Ahead of tomorrow’s start of week-long activities in observance of Cervical Cancer Prevention Week, which concludes on January 27, this country’s only female gynaecologic oncologist, Dr Vanessa Harry, is calling on stakeholders in the health sector to get serious about women’s reproductive health.
She said thousands of women’s lives could be saved if T&T implements a comprehensive national Pap smear screening programme in the fight against cervical cancer, which is growing at an alarming rate with more than 200 diagnoses annually.
Harry said although cervical cancer is a potentially preventable disease, it was still too prevalent in T&T and that was as a result of a non-existing comprehensive approach that includes prevention, early diagnosis, effective screening and treatment programmes.
“Cervical cancer is actually very slow growing, it progresses through from subnormal to pre-cancerous changes and can last for years and years before it can develop into cancer. So all that in between phase of pre-cancer is what leads to early detection. That is why we so strongly continue to advocate for Pap smears to be done. During this screening, pre-cancer changes can be detected before cancer develops,” she explained.
Harry reinforced that cervical cancer, the fourth most frequent cancer in women, is caused by the Human Papilloma Virus (HPV), which is also detected through pap smear screenings.
According to the WHO in 2018, an estimated 570,000 new cases of cervical cancer were diagnosed, representing 6.6 per cent of all female cancers.
It also stated 90 per cent of deaths from cervical cancer occurred in low and middle-income countries.
Regarding screenings, Harry said its been reported by some epidemiological studies in T&T, that less than five per cent of women of screening age actually access screening. This was not good. she said as it would mean that all the pap smears done at public health institutions would account for less than ten per cent of the number of Pap smears that actually needed to be done.
But it was “tricky” she added, when it came to gathering definite statistical information on screenings, as there is no national screening programme where tests are sent to a central lab, which would aid in quality control of statistical reporting.
“There are so many labs both in the private and public health sector and some people even send tests abroad. So you don’t really know how the quality of reporting is. This results in poor data collection and unconfirmed and unsubstantial statistics. There has to be appropriate training to report these things accurately and for the purpose of following up on them,” Harry said.
Asked why was it still so much of a challenge to get women to do pap smears, Harry listed, four reasons; fear, finance, forgetfulness and lack of education. She fixated on the latter, saying though there is a level of personal responsibility to be factored in, there needs to be a continued “in your face” approach, that would serve to constantly remind and educate women on the importance of Pap smear screenings as well as all things related to reproductive health.
She pointed to countries like the United States, United Kingdom and Australia, which embark annually on Pap smear screening programmes for women, saying T&T needs to “take note.”
“In countries like the UK with a well-established screening programme, its cervical cancer rate is probably at number 13 or 15 in all the cancers which affect women. For us in T&T, in gynaecological cancers, cervical cancer stands at number one, surpassing all other gynaecological cancers, including ovarian and uterine cancer.”
She referred to the “terrific” campaigning that was done when poliomyelitis (polio) was the “big” disease-affecting children and said due to all its campaigning and advertising for parents to get their children vaccinated, this eventually led to the eradication of the disease. She said it was is this same aggression T&T needs to approach the potential eradication of cervical cancer.
“Don’t just do another drive! Create a well-sustained national screening programme with all the reminders and information available. And if someone still develops cervical cancer, you can go back and look at all the previous pap smears done to see why or how it might have happened.”