Experts call for more cervical cancer tests

According to Professor Kimlin Tam Ashing, Professor, Department of Population Sciences and Director of the Centre of Community Alliance for Research and Education, City of Hope US, screening should start among females 18 years-old. However, she qualified this statement saying it should take place at the time of sexual initiation.

“Unfortunately, that could be 12 or 14 so at that age if the child, she is a child, has begun sexual activity she really needs to be getting a pap test,” she said at the launch of the research study, “Role of Stigma in Cervical Cancer Screening in Trinidad and Tobago” at the Carlton Savannah. Among its aims is to identify the barriers to cervical cancer screening.

Cancer is the second leading cause of death in TT and data from the National Cancer Registry indicated that cervical cancer is the second leading cancer among women. Breast cancer ranks first. The pap smear test can be done annually or more frequently depending on what is found in the cells. Cervical cancer is caused by the human papilloma virus (HPV) which is sexually transmitted and can cause cancerous cellular changes which affect the area at the opening of the uterus.

“It is one of the most common cancers among women globally, the second most common cancer in TT. It is a cancer which should have been eradicated 30 years ago with the pap smear test came into being but it is still with us”.

Ashing-Giwa said the pap smear test picked up cellular changes before they reached the cancerous stage. She said early detection in women in their 20’s and 30’s can prevent cancer developing even if HPV was detected. She said the pap test was still unacceptable and unaccessible to many women.

Ashing-Giwa said vaccines were available to prevent certain strains of HPV and one is being developed for men. She said there were precautions which can prevent HPV—delaying sexual initiation, early education of young girls, limiting the number of sexual partners and condom use.

Ashing-Giwa said women are often face the stigma associated with cervical cancer. She said some studies have shown that male partners blamed women for getting the disease. “She’s monogamous. He’s the one bringing the disease but because she’s the one who manifests the disease she is the tainted one. It’s important to look at the whole family in terms of preventing this disease.”

For the period January 2002 to December 2006, cervical cancer accounted for 12 percent of all cancer cases among females and was highest in the 40-44 and 45-49 age groups. Deaths were highest in females 45-49, 55-59, and 65-69.

Veronica Roach, Registrar, said cancer was the second leading cause of death among women and contributed to “potential years of life lost” in women which was the number of years lost through premature death (before the age of 75) resulting from a particular cause. Roach said women needed to be educated about the dangers of not having pap smears done.

Chairman of the TT Cancer Society (TTCS) Dr George Laquis said many women did not go for screening because they showed no symptoms of disease. He said the incubation period for cervical cancer was 10-20 years from the first abnormal cells to becoming invasive cancer of the cervix.

Laquis said the TTCS screening has detected cervical cancer in women in their 50’s and 60’s which would have started ten to 20 years before. He said the research from the study will be useful in directing resources and improving messages to the public so the TTCS will know where it should be “exerting our efforts.”

The study is seeking women volunteers between the ages of 18-70 years to be part of a survey and follow up three months later. Interested persons can contact Susan Phillip at 780-4297.

CERVICAL cancer symptoms often go unnoticed because they mimic so many other ailments. Many women pass these symptoms off as PMS or ovulation pains. Many times, however, cervical cancer has no symptoms.
When symptoms are present, they usually do not appear until the cancer is more advanced. This does vary from woman to woman.

Cervical Cancer Symptoms
Abnormal bleeding. Women with cervical cancer may experience abnormal vaginal bleeding. This can be heavy or light bleeding during the month.
Unusual heavy discharge. An increased vaginal discharge is also a symptom of cervical cancer.

It may be foul smelling, watery, thick, or contain mucus. It varies from woman to woman. It is important to report any unusual vaginal discharge to your doctor.
Pelvic pain. Pelvic pain that is not related to the normal menstrual cycle can be a cervical cancer symptom. Many women describe them ranging from a dull ache to sharp pains that can last hours. It can be mild or severe.

Pain during urination. Bladder pain or pain during urination can be a symptom of advanced cervical cancer. This cervical cancer symptom usually occurs when cancer has spread to the bladder.

Bleeding between regular menstrual periods, after sexual intercourse, douching, or pelvic exam. Bleeding after sexual intercourse, douching, or pelvic exam can be cervical cancer symptoms. This is due to the irritation of the cervix during these activities. While a healthy cervix may have a very small amount of bleeding, many conditions may cause bleeding after activities like sex.