Cervical cancer, Pap smear | The consequences of not checking yourself can be disastrous

Cervical cancer, Pap smear | The consequences of not checking yourself can be disastrous
Cervical cancer, Pap smear | The consequences of not checking yourself can be disastrous
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The comment expresses the writer’s opinions.

(Trønder debate): «How is the abdomen? Time for a check?»

It says on the poster welcoming me into the women’s changing room at my local gym.

In January, the message on the poster made an extra impression. How is it really? Is it soon time for another check? In the first month of each year, the Swedish Cancer Society organizes the checkdeg campaign, which encourages women to have a cervical smear.

It’s no secret that women’s health has been a low priority for a long time. Long treatment time, long time to make diagnoses. In research into diseases affecting both sexes, the male body has been considered the norm. Therefore, for example, most of us know what men’s symptoms of a heart attack are, but not how women react to the same condition.

Many women have told about how they experience not being taken seriously by healthcare personnel. Among other things, we got many examples of this in Trønderdebatt’s women’s health series.

Fortunately, great progress has been made in some areas of the women’s health field. As in prevention against breast and cervical cancer. For two of the most frequently occurring forms of cancer in women, it should just be missing.

The number of cases of cervical cancer has decreased for several reasons – national HPV vaccination of girls in the 7th grade, the cervical program and the sjekkdeg campaign.

It is so important that the investment in these areas has worked. Prevention works, screening and the cervical program means that fewer people develop cancer, and that the cancer that is detected is less dangerous – because it is often in an early stage. This means that lives are saved.

«Cervical cancer almost eradicated in Norway by 2039» reads the headline of an FHI article published in March 2021. This goal is realistic. In 2022, my litter, the first litter to be vaccinated against the HPV virus, turned 25 years old. We were thus accepted into the cervical programme, and last year it became clear that no one from my litter developed cervical cancer. The vaccination works, as does the program.

But. There is always one but.

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When should you go to the doctor?

There are around 190,000 women who have not had a cervical smear in the last 10 years. The consequences of not checking yourself can be disastrous. Cervical cancer that is not detected in time, which is allowed to develop in peace and over a long period of time, can in the worst case lead to incurable cancer.

For many years, women have marched on 8 March and demanded prioritization of women’s health, we have demonstrated to be taken seriously. It will therefore be too stupid if we are not going to be able to achieve the goal of eradicating this women’s health disease because so many people choose not to get tested.

This is actually on us women. We must follow the checkdeg campaign’s message to call the GP, book a doctor’s appointment and take the cervical test when we get a reminder from the cervical program. But it also depends on the availability to get tested, the quality – and access – to information about the programme, and how easy it is to make use of the offer.

The Norwegian Cancer Registry has worked on this problem, and has, among other things, proposed home tests to increase participation. This year, for the first time, women who have not had a cervical smear in the last ten years will be sent a home test in the post. It’s a seven-mile step in the right direction.

Three out of ten women do not have a cervical smear regularly. Then the HPV test in the post is a good alternative, but it is not good to wait 10 years for the postal delivery. The Women’s Health Committee points to several reasons why women do not have cervical smears.

Among other things, there are fewer women with an immigrant background who participate in the cervix programme. The Women’s Health Committee points to language barriers and complicated information letters as contributing factors. In the Women’s Health Committee’s report, they point out that short information letters with clear recommendations to participate, and that GPs who receive concrete recommendations on how to reach out to women with an immigrant background, have a good effect on participation.

Other reasons why women choose not to check themselves are, according to the Women’s Health Committee’s investigation, that it is easy to forget, that women have to book the doctor’s appointment themselves, and that the examination is perceived as uncomfortable.

I have no say in the latter explanation. It is not difficult to understand that it is possible to be reluctant to go to the GP for a gynecological examination. I did the same when I received my first reminder from the cervix program two years ago. After going out on a limb myself and almost giving a public sermon about the importance of getting tested, I – somewhat reluctantly – booked an appointment.

I’m glad I did. Two years later and one cervix poorer, I have learned that going to the gynecologist does not have to be embarrassing or uncomfortable. But much, much more important – that cell changes that are detected early will not develop into something dangerous, and that can save lives. I was never in any real danger of developing cervical cancer, and thanks to the Cervical Program I won’t be either.

(Firda.no): This is what happened when Firda journalist Ina Christin Løvseth visited the gynecologist. She has finally taken a pap smear after postponing the check for eight years.

Luckily I had a GP to go to. Figures from October 2023 show that over 200,000 are without a GP. Then it is not as simple as simply “calling the GP”. And for those with a GP, not everyone wants to have a cervical smear there either. Perhaps there are bad experiences with gynecological examinations in the past, perhaps there is a desire to take the test at a gynecologist, perhaps it is something else entirely.

But the options are not many. Either go to the GP, and then possibly be referred to a gynaecologist, or pay NOK 2,000 to take the test privately. The threshold and price for having a cervical smear can be high.

So maybe we have to think about prevention and the cervical program in a different way than just calling the GP? The health centers in Nordre Follo are examples to follow. In mid-January, they organized a pap smear day where women were offered a pap smear at the municipality’s midwives – free of charge.

The Cancer Society encourages doctors’ offices, health centers and gynecological departments to organize a checkyourday . It can be a drop-in or an appointment, during the day or in the evening – just as Nordre Follo did.

I told a friend about Nordre Follo’s brilliant checkdeg concept. Her response was blunt. “Can we have it?”. I hope we can get an almost identical low-threshold offer in Trøndelag. At St. Olav, at Levanger hospital and at Namsos hospital. At the doctor’s office and health centers in the county.

January 2024 is now a closed chapter, but the checkdeg campaign is not. It is important to check yourself, also in February, March – and the rest of the year.

And for the women with busy everyday lives or who simply forget to get tested? Here, the rest of us have a job to do.

Check yourself – and encourage women you like to do the same. Ask your wife, girlfriend, mother, daughter, sister, grandmother, granddaughter, girlfriends. Women between 25 and 69. How is the abdomen? When did you take your last check?

Take these reminders and prompts seriously. The next time you see a poster reminding you to check your abdomen on the way into the ladies’ locker room, you can pick up the phone and book that doctor’s appointment.

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The article is in Norwegian

Tags: Cervical cancer Pap smear consequences checking disastrous

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