More women need to be screened for cervical cancer

Up to 30 per cent of Canadian women are not being regularly screened for cervical cancer, and the lapse is resulting in unnecessary cases of cervical cancer every year, say University of Alberta obstetrics and gynecology residents.

“Every year, 1,500 women are diagnosed with cervical cancer and 400 will die,” said Lindsay Drummond, a second year OB/GYN resident in the Faculty of Medicine & Dentistry. “The earlier the cancer is screened for and caught—through a Pap test—and treated, the better the prognosis.”

“In fact, if more women are screened for cervical cancer, and gender-neutral HPV [human papillomavirus] vaccination rates increase, there’s a very good possibility Canada could be the first country in the world to eradicate cervical cancer by the next generation of women,” added Kristen Black, a third-year OB/GYN resident.

Currently, only 67 per cent of women are screened for cervical cancer. Alberta Health Services (AHS) has said it would like to see the rate go up to 80 per cent.

According to the Pan-Canadian Cervical Cancer Screening Network (PCCSN), well over a third of women diagnosed with invasive cervical cancer had not had a Pap test in the previous five years or ever. The Public Health Agency of Canada reports that 15 per cent of women have never had a Pap test.

“Unfortunately, a number of obstacles prevent women from being screened that include a lack of awareness of the risk, due in part to lower incidences because of increased screening, women not having a family physician or not having a family physician who offers Pap tests, or women choosing not to have a Pap test because it is uncomfortable,” said Drummond.

A Pap test is a safe procedure that removes a small sample of cells from the cervix, said Black. Cells are looked at under a microscope to see whether they are normal or abnormal, and if they are abnormal, they can be removed before they become cancerous, she added.

Health Canada advises women to start Pap tests when they’re 25, or three years after becoming sexually active, and make them part of their regular health routine every three years.

Preventing cervical cancer

Risk factors for cervical cancer include infection with HPV, sexual activity, smoking and a history of sexually transmitted infections, said Drummond.

“Your number one preventive step is to get a Pap test every three years. In developing countries with screening programs, cervical cancer is the most common cancer in women and the most common killer cancer,” she noted.

“Quitting smoking is also important, as is protecting yourself against HPV, and the best way to do that is to get an HPV vaccination,” added Black.

Two strains of HPV cause more than 90 per cent of cervical cancer cases, she said, adding there are many different types of HPV.

“Most women who develop cervical cancer have had an HPV infection at some point in time. In fact, over 75 per cent of people will have had an HPV infection in their lifetime that may have been symptomless and cleared up on its own,” said Black.

“Of course, having an HPV infection doesn’t mean you’ll develop cervical cancer, but getting a vaccine to reduce your exposure is a critical prevention measure,” said Drummond. “And the vaccine can also reduce your risk of other cancers caused by HPV including oropharyngeal, anal, vulvar and vaginal cancer.”

Health Canada approved the HPV vaccinations in females aged nine to 45 and males aged nine to 26.

“Even though the vaccine is most effective before one is sexually active, there are still benefits to getting one after,” noted Black. “It helps the body’s immune system fight HPV and it provides lifelong immunity.”

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