Alice Tagwira
Beyond Boundaries
October is Breast Cancer Awareness Month. The world turns pink, but for women in Zimbabwe and Africa, pink is only part of the story.
In 2024 alone, Zimbabwe recorded 25 125 new cancer cases and 16 378 deaths, with women accounting for 15 132 of those new cases. For women, two cancers dominate the burden — cervical and breast — but ovarian, uterine and vulvar cancers are rising fast and are often ignored until it is too late.
- CERVICAL CANCER: ZIMBABWE’s NUMBER ONE KILLER OF WOMEN
Cervical cancer is the most common cancer among Black women in Zimbabwe, making up 40.1% of all cancers in this group and nearly a third of the national burden. Nationally, it accounts for 40% of all cancers among women.
According to WHO and Ministry of Health data, approximately 3 043 women are diagnosed and 1 976 die every year from cervical cancer in Zimbabwe.
In Africa, the picture is worse. Cervical cancer is now the leading cause of cancer death among women in sub-Saharan Africa, with Africa recording 253 000 new cases in 2023, just behind breast cancer at 267 000 cases. Globally, more than 266 000 women die of cervical cancer each year, and 87% of these deaths happen in less developed regions like Africa.
Main Cause: Almost 100% of cases are caused by persistent infection with Human Papillomavirus (HPV), a sexually transmitted infection.
Major risk factors in Zimbabwe:
Early sexual debut and multiple sexual partners
High HIV burden — women living with HIV are 6 times more likely to develop cervical cancer
– Smoking, high parity, long-term use of oral contraceptives
– Low screening — as of 2019, only 20% of the population had access to screening, and earlier studies put coverage as low as 13%.
DID YOU KNOW?
Cervical cancer takes 15-20 years to develop after HPV infection. That means if screened with VIAC or HPV DNA test, precancerous cells can be frozen off by cryotherapy before they become cancer. It is one of the most preventable cancers in the world.
BREAST CANCER – THE SECOND MOST COMMON IN ZIMBABWE, FIRST IN AFRICA
In Zimbabwe, breast cancer is the second most common cancer in women after cervical cancer, and numbers are rising consistently. In Africa as a whole, it is now the most diagnosed cancer at 267 000 cases.
The Zimbabwe National Cancer Registry shows peak incidence is between ages 30-60 women in their prime productive years.
Major causes and risk factors many women don’t know:
Non-modifiable: Age over 40, family history and BRCA1RCA2 genes, early menstruation (before 12) and late menopause (after 55)
Reproductive: Never having children, first child after age 30, not breastfeeding
Lifestyle: Obesity, alcohol, smoking, lack of exercise, unhealthy diet high in processed fats
Hormonal: Long-term hormone replacement therapy after menopause
Early signs: Painless lump in breast or armpit, nipple discharge (especially bloody), change in size/shape, skin dimpling like orange peel, persistent breast pain.
DID YOU KNOW?
In Africa, despite lower incidence compared to Europe/USA, breast cancer has some of the highest mortality rates globally because over 70% of women present at Stage 3 or 4.
CANCER OF THE UTERUS (ENDOMETRIAL & CORPUS UTERI)
Often confused with cervical cancer, but different. It affects the body of the womb, not the cervix. Data from Harare (1990-2019) shows the age-standardised rate in Zimbabwe is 9.2 per 100 000, higher than the sub-Saharan average of 3.4 per 100 000.
Major cause: Too much estrogen. Obesity is the number one driver — fat tissue produces extra estrogen. Zimbabwe’s rate of women with BMI 25 rose from 23% in 1994 to 34.9% in 2015, driving the increase.
Risk factors: Obesity, diabetes, hypertension, never having children, taking estrogen-only therapy.
Sign: Any vaginal bleeding after menopause, heavy periods, pelvic pain.
DID YOU KNOW?
Uterine cancer is often curable if caught early, but abnormal bleeding after menopause is considered taboo and many rural women attribute it to witchcraft, delaying care by months.
OVARIAN CANCER – THE SILENT KILLER
Accounts for about 3.5% of cancers in Zimbabwean women and is known as silent because symptoms mimic normal stomach problems.
Major causes: No single cause, but linked to inherited BRCA genes, family history of breast/ovarian cancer, endometriosis, never having children, and late menopause.
Warning signs: Persistent bloating, feeling full quickly, lower abdominal pain, frequent urination — symptoms lasting more than two weeks.
DID YOU KNOW?
There is NO effective screening test for ovarian cancer worldwide — not even Pap smear or VIAC detects it. Diagnosis relies on symptom awareness and ultrasound. This is why it kills quickly.
VULVAR CANCER – THE FORGOTTEN HPV CANCER
Rare but rising in Zimbabwe. Rate is 2.1 per 100 000, high by global standards (0.83 globally). Strongly linked to HPV, same virus causing cervical cancer.
Zimbabwe launched HPV vaccination in 2018 targeting girls 10-14 years and has reached over 2 million girls. Since end of 2023, Zimbabwe introduced HPV DNA self-sampling kits in about 200 clinics, allowing women to test in privacy at home.
Your 5-Point Action Plan:
- Vaccinate: HPV vaccine for girls 9-14 before sexual debut. It prevents 90% of cervical cancers.
- Screen: VIAC every 3 years from age 25-49, HPV DNA test every 5 years. Clinical breast exam yearly.
- Self-exam: Breast self-exam five days after your period monthly.
- Healthy life: Maintain healthy weight, exercise 30 minutes daily, reduce alcohol, stop smoking, breastfeed if possible.
- Speak early: Any abnormal bleeding, discharge, lump or bloating lasting two weeks — go to your nearest clinic immediately. Do not wait.
Cancer is not a death sentence if caught early. But in Zimbabwe, more than 70% of cervical cancer patients die because they come late. We can change that.
This October, go beyond wearing pink. Get screened. Get your daughter vaccinated. Save a life — maybe your own.
