Did the headline get your attention?
Hopefully it did, because that was really half the point of including the word ‘sex’ in a post about preventing cervical cancer. Although to be fair, sex does have a lot to do with cervical cancer, so the headline wasn’t just a cheap marketing ploy.
Many women in Australia don’t realise that cervical cancer is one of the most preventable cancers. In fact, up to 90% of cervical cancer diagnoses are avoidable with two-yearly Pap tests (smears).
Despite this good news, only around 60% of eligible Australian women are screening as recommended under the National Cervical Screening Program.
Why is this, ladies? From our research at PapScreen Victoria, the most common reasons for women to avoid having regular Pap tests is embarrassment, a lack of understanding as to what it’s all about, and believing they’re not at risk.
PapScreen Victoria, the cervical cancer prevention program within Cancer Council Victoria, has launched a new campaign to try and address these issues. The campaign revolves around a racy new video depicting an intimate scene between a couple that is dramatically, and rather unexpectedly, interrupted. We suggest you watch the video to see why.
The risqué concept is a new approach for the Cancer Council, which is hoping the enticing combination of sex and humour will help cut through common misconceptions about cervical screening and motivate more women to take part.
The video is designed to remind (or inform) women that cervical cancer is caused by an STI called the human papillomavirus (HPV), and if they have ever had sex, they are at risk of developing the disease.
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Is it possible to have a test to see if you have the HPV virus?
They can certainly test for HPV, but as far as I know, it's only covered by Medicare if you've had "treatment" after an "abnormal" pap test. That makes no sense of course, we should offer women HPV testing first, before even thinking about pap tests.
You could ask your doctor if you could pay for a HPV test yourself, but our GPs receive target payments for pap testing and the target was recently increased to 70% of eligible patients, so you are likely to be encouraged to stick with the excessive pap testing program. (PIP scheme)
I know women are now flying up to Singapore to use the self-test device, the Delphi Screener, you can test yourself for HPV and then you know where you stand...positive and you have a small chance of benefiting from a 5 yearly pap test from 30 to 60 or until you test negative for HPV, if you're HPV negative you can't benefit from pap tests and might consider re-testing for HPV in 5 or 10 years time, depending on your age. Of course, those HPV negative and no longer sexually active or confidently monogamous might choose to forget all further testing. I doubt we'll see the Delphi Screener in this country and if we do, it'll probably be locked behind a doctor's script and when they get target payments for pap testing, I doubt many women will get to the Delphi Screener. The only HPV primary test you might be able to access here and pay for yourself is an invasive test, similar to a pap test.
When you urge women to seriously over-screen it shows they have no concern or respect for our bodily privacy. Tampap is also being used in the UK so there are reliable self testing HPV options, but they are not being offered to Australian women.
Countries that promote excess, in my opinion, like the States and Australia, do not have evidence based programs.
Women will have to demand a program that actually helps women and the option of self testing, this would prevent more of these rare cancers and just as importantly, protects the vast majority of women who are "not at risk" (HPV negative) from a lifetime of unnecessary pap testing and the fairly high risk from false positives, excess biopsies and over-treatment. (made much worse by serious over-screening)
The Delphi Screener is also available in The Netherlands, it was actually invented by Dutch gynaecologists...and Malaysia, Italy and a few other places. You can check out their website for more information, Delphi Bioscience. HPV Today, Edition 24, sets out the new Dutch program.
The Dutch asked experts to give their personal professional opinions (their reputations would be on the line) on an improved program, NOT as representatives of their professional bodies...that way you reduce the risk of bias and the influence of financial and other vested interests.
In the ABC Health Report with Dr Norman Swan, you'll find a three part series on the risks and benefits of cancer screening...our Dr Alex Barrett says we are "massively" over-treating, she's right, it should be a scandal, yet is allowed to continue...no one is warning or protecting women.
A review of our program is finally underway, but I'm not confident much will change, those that have protected excess will no doubt exert their influence yet again. The key here...become informed and find a doctor prepared to work with you and not simply follow this excessive program....protect your body, health and well-being.
Note: HPV primary testing is not recommended for those under 30 as 40% would test positive, almost all are transient and harmless infections that will clear within a year or two, by age 30 only roughly 5% are HPV positive, these are the ONLY women who have a small chance of benefiting from a 5 yearly pap test. (2 or 3 yearly pap testing is over-screening and just produces more false positives for no additional benefit over 5 yearly testing)
Pap tests - be very careful before age 30, no country has shown a benefit pap testing those under 30, but young women produce the most false positives and this can lead to some ugly places. In "Cervical cancer screening" in Australian Doctor, July 2006, our Associate Professor Margaret Davy, Gyn-Oncologist and Dr Shorne stated that no country in the world has shown a reduction in the incidence or mortality from cervical cancer in women under 30, irrespective of cervical screening and that many countries do not perform pap testing on those under 30.
So, why are we still testing young women and some are even being tested in their teens? This IMO, is a very serious matter. When change is finally made to our program, they must remove those under 25 from screening, yet even at this late stage they are still urging young women to not only test, but over-screen. It's hard to understand the motivation here...we simply distress and harm lots of young women.
Yet again, more incomplete, and disingenuous information from a pap screening authority. Where are the actual statistics (NOT percentages, but actual numbers) of the women this test has claimed to "save" from cervical cancer? Why are we not adopting the Finnish way of screening and testing for cervical cancer? They have the lowest rates of cervical cancer in the world, and have done for decades, yet they only test 5 yearly and only IF the woman considers herself high risk. They also don't start testing until a woman is 25 -30 years old, due to the huge amount of false positives thrown up by younger women.
Women who have never had sex, women in a monogamous relationship, lesbians, women over 65, women who have had their cervix removed due to non cancerous related issues DO NOT need a pap smear. In fact, no one NEEDS or MUST HAVE a pap smear, it is an elective screening tool. No more, no less. A pap smear will not detect cancer, it will not detect STIs, it will not detect anything except abnormal cells. No doctor in the world can know if a high grade abnormality will turn cancerous, and it is well proven that low grade abnormalities up to CIN 3 will in most cases clear up on their own, especially in women under 30. Why are we still using this outdated, unreliable test when there are so many other more reliable ways to screen for cervical cancer?