Cervical cancer is the second most common cancer in the world and one of the deadliest chronic diseases affecting women. In Afghanistan, most women are largely unaware of it, increasing their vulnerability. This report is based on interviews with 17 women from eight provinces, all of whom said they are unaware of the disease, its symptoms, or risks.
The women said their vulnerability is worsened by traditional family attitudes, shame about visiting doctors, poverty, illiteracy, and the lack of screening and treatment centers. Five of the interviewees are currently living with cervical cancer.
Ozra, a resident of Bamyan said she had been sick for three months but didn’t seek medical help because she didn’t know the signs. “I had a lump in my uterus and was bleeding for three months. I finally went to the doctor, had CT scans, and was diagnosed. Now I’ve had surgery. Six months ago, I was sick but didn’t seek help. My condition worsened over three months; I was bleeding, and I thought it was just from the contraceptive injection,” she said.
The lack of professional medical staff and treatment centers in districts and provinces makes the problem worse.
Hoori Jan, from Herat, said she waited a year after diagnosis to seek treatment. Misdiagnosis and the shortage of skilled personnel forced her to travel to Kabul.
She explained, “I’ve been bleeding for a year. I went to an obstetric-gynecologist, and they said my blood sugar was high. A month ago, I could not urinate and paid 14,000 Afghanis for tests and an ultrasound. They said it was a kidney problem. I am in pain, like labor pain. The doctor said my uterus has a problem. I have a boy, he is unemployed, and my daughters help me. Our house has no carpet, and all our properties are still in Iran.”
Doctors say cervical cancer is mainly caused by the human papillomavirus (HPV), underage marriage, and early childbirth. Poverty, low awareness, and families’ misconceptions about early marriage also contribute to its spread.
Qaderman, a 25-years-old mother of six children, said she married at age 15 and had cervical cancer for two years. She began treatment this summer, borrowing money from relatives.
She said, “I was 15 years old when I got married. I’ve been sick for two years. There was a lump in my abdomen that didn’t go away without surgery. I had a curettage and was told I would be healthy. Later, I had bleeding, and a growth appeared in my vagina. I had it treated, but now the extra growth is gone, and I still have heavy bleeding.”
Even though cervical cancer can be prevented and treated with regular screenings, low awareness remains a major factor in women’s deaths.
Shukria, resident of Faryab, said she still has no knowledge of the disease and can’t visit clinics because of family shame.
She said: “I don’t understand anything about cervical cancer. If I have pain or infection in my genital area, I feel ashamed and usually don’t tell anyone. In our province, there are not many female specialist doctors, and even at the health center, examinations are basic.”
At the National Cancer Control Program in Kabul, the only cancer treatment center in Afghanistan, doctors face shortages of equipment and skilled staff.
Samira Shahir, an obstetric-gynecologist, said the lack of radiotherapy sometimes forces them to remove patients’ body parts.
She added, “Since I started in oncology, patient numbers have increased. We need MRI, radiotherapy, and CT scan services, and capacity-building programs for staff. We have a laparoscopy machine, but no skilled staff to prevent damage during biopsies. Breast cancer patients need radiation, but we don’t have it, so sometimes we must remove body parts.”
Liza Shamriz, another obstetric-gynecologist, said cervical cancer has no clear early symptoms but later causes irregular menstrual cycles, abnormal bleeding, and pain after intercourse. She stressed that early diagnosis greatly improves treatment chances.
She added, “In the beginning, this disease has no symptoms. Over time, it causes irregular periods, foul-smelling discharge, abnormal bleeding, and pain after intercourse. The earlier it is diagnosed, the higher the chance of successful treatment.”
Sunita Bahram, another obstetric-gynecologist doctor, said, “The level of awareness among women in our country is very low. Most women don’t even know that a persistent infection in the genital area can lead to cervical cancer.”
Officials from the Ministry of Public Health of the Islamic Emirate said there’re no accurate figures on cancer patients.
Spokesperson Sharafat Zaman Amarkhil said specialized cancer hospitals will be built in five zones, and a 200-bed hospital has already opened in Kabul.
He added, “Building 50-bed hospitals in five zones and a 200-bed hospital in Kabul will partially solve the problem. The central hospital will provide radiotherapy, chemotherapy, and other necessary services. Currently, we already offer inpatient, diagnostic, surgical, and chemotherapy services.”
According to the WHO report, 43% of deaths in Afghanistan are caused by heart disease, diabetes, cancer, and respiratory illnesses. By 2030, these diseases are expected to increase by 60%.
Reporter: Nilofar Mohammadi
