THREE hundred and forty-two thousand women died in 2020 from cervical cancer worldwide. That’s a little over half the number of women diagnosed with cervical cancer in 2020. What’s more striking is the continued disparity between First and Third w orld countries. The majority of these cervical cancer diagnoses occur in black women in poorer communities, mirroring the poor access to health care in this population.

In Jamaica, cervical cancer is the third leading cancer found in women, and the fifth leading cause of cancer-related deaths. In 2020 alone we recorded over 386 new cases and 247 deaths.

Impact of cervical cancer

Private surgery and chemo-radiation can cost millions of dollars in the private setting, an amount that can easily wipe out health insurance, critical illness policies, and the majority of middle-class savings. Even for those using the public health system, the delay in getting care usually means longer treatments and, in some cases, progression of disease while awaiting treatments. In addition, many women lose significant income by being absent from work, and some are unable to return to their jobs because of long-term therapies. The families of cervical cancer patients are often devastated as many of these women are active contributors to the household. Psychologically, this toll pops up as depression, anxiety, and increased stress-related symptoms in both the patient and her dependents.

How can we reduce our numbers?

The First World countries have realised what we all know, prevention is better than cure. There are few cancers that we can detect before they actually turn into cancer, and cervical cancer is the easiest to detect. The USA has seen over a 50 per cent reduction in cancer diagnosis and death after designing and implementing proper screening guidelines.

Jamaica has guidelines set out by the Ministry of Health and Wellness, but somehow that has not translated into the same kind of success seen worldwide. Our population is not as health-seeking as our First World counterparts. We still only go to the doctor when something is wrong rather than going in for a wellness check-up. Others prefer unverified herbs and teas to treat their issues rather than standard medical treatments. This fear or mistrust of the health-care providers has led to many women skipping out of their cervical cancer screening, only to end up in hospital when it’s too late. Too many young women in their 30s, 40s, and 50s have died because they never had a Pap smear, or had one but never got the results.

How often do you need to screen?

The current guidelines state that a Pap smear is recommended every three years, and if you are over 30, then you can combine it with an human papillomavirus (HPV) test and extend your screening to every five years (If you still want it done every year then you can). Certainly it is not a difficult task to go for a check-up every three to five years. However, to put the onus on our population to just “do better and come out” is not enough. In the best screening centres, there are records of patients which are used to contact them to come in for screening and also to come in for results. If patients are not contacted at first try, they are called and called until they get them. This rarely happens in our public system, and if they are unable to contact you, your result is usually filed away until you return for a check-up or ailment. This inefficiency has contributed to many late diagnosis of cervical cancer and needs to be addressed if we want any real change. The Jamaica Cancer Society makes valiant efforts every day to help with screening, but with limited funding there is only so much they can do. What we need is a better national screening programme. One that reaches every eligible woman, one that won’t stop until abnormal results are communicated, and one that ensures proper referrals for treatment of pre-cancerous cells.

For 2022 and beyond, make it your resolution to do a Pap smear or encourage your loved ones to get it done and follow through with their cervical cancer screens.

Dr Ryan Halsall is a consultant obstetrician gynaecologist who operates at ILAP Medical, 22 Windsor Avenue, Suite 2, Kingston 5. He can be contacted at info@ilapmedical.com or 876-946-0353. Follow him on Instagram: @drhalsall