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One for the ladies

Monday 30 August, 2010 by Helen

Our new PapScreen campaign Peace of mind was launched with great fanfare and lots of mini-quiches last week - watch it here! You like the new PapScreen website too you say? Very kind! But seriously, we welcome any feedback about the advert and the website, positive or (gulp) negative.

At the launch, we released new stats showing one in two young Aussie women are not having Pap tests every two years as recommended. So essentially either you, or your best mate: officially not screening. If you're aged 20-29 that is, and you have a best mate ... I'm sure you do.

But older women don't get off scot free either - at the launch we also revealed the latest Victorian screening stats for women aged 20-69 and the results were pretty shocking. Only 61.3% are having regular Pap tests, the lowest number in a decade. So one of you, your best mate and your sister: not screening.

I've been working at PapScreen for almost a year now, but I still find it hard to believe that well over a third of women don't go for Pap tests.

I thought everyone (women, obviously) just WENT for Pap tests every two years. To be honest, I don't I think I knew why I went for them, or even how I found out I should - my Mum certainly didn't tell me ... thanks Mum!

I just did.

So why is it that so many women don't?

I mean: take time out of your busy day, blush furiously as you tell the doctor or nurse you'd like a Pap test, strip halfway down in front of a stranger, assume a very compromising position, then have a dab of your cells taken out and whisked off to a lab where perfect strangers look at a tiny piece of your insides very closely through a microscope.

Don't all rush at once.

I think the best - maybe only - way to deal with the whole thing is by retaining an extremely healthy (as healthy as your cervix will be) sense of humour. It's just one of the many awkward things woman have to do - skirt-tucked-inside-underwear incidents, buying tampons from spotty male youths ... the list goes on.

Practising your humour maintenance aside, there are some extremely good reasons why every women should put booking a Pap test at the top of their to-do list if they're overdue:

1. Almost 90% of women diagnosed with cervical cancer in Victoria either never had a Pap test, or had not had Pap tests regularly before being diagnosed. I'm no statistician, but we can assume that this percentage would roughly apply Australia-wide.

2. It's one of the very few cancers that can be pretty much prevented (Pap tests can prevent around 9 in 10 cervical cancers). Having Pap tests allows women to take control of their bodies and say with a large degree of certainty that "cervical cancer will not happen to me".

In short, women should be flocking in their droves every two years to take advantage of this test, one of the great discoveries benefiting the fairer sex - which was, incidentally, tried and tested by a Greek doctor (Dr Papanicolaou) in the early twentieth century on his long-suffering wife, who manfully (or womanfully) allowed him to try out his prototype ‘Pap test' on her almost EVERY SINGLE DAY FOR 20 YEARS.

Now there's a woman with a sense of humour.

I'll leave you with a line from our new ad, in the hope that it - and this blog - will mean you pick up the phone to book that test if you're overdue.

Every women, every 2 years. Pap tests - a little awkward for a lot of peace of mind.

Have you seen the new ad? Are there things you do that are equally as awkward but you barely think about?

Thank you to everyone for their comments. This blog post is now closed.


Response to D Brown from Cancer Council Victoria.
Thank you for taking the time to share your concerns regarding Pap testing. As an organisation we (Cancer Council Victoria) aim to provide clear information to women, in order for women to consent to – or opt out of – cervical screening in an informed way. We acknowledge that cervical cancer is rare in Australia – when compared with breast cancer, for example, and that Australia does commence screening at an earlier age and more often than other countries. However, we know that cervical cancer incidence and mortality rates are low because of the screening program. Research shows us that if incidence and mortality rates had remained at the levels they were before the screening program started 18 years ago, a further 2075 Victorian women would have been diagnosed with cervical cancer, and a further 685 would have died. It also helps to reflect on cervical cancer at a worldwide level, where it is the second most common cancer for women, with more than 288.000 deaths each year – mostly in countries where there is no screening program. Pap tests aren’t perfect, no screening test is. But they can detect 90% of the most common cell changes which can lead to cervical cancer. National Health and Medical Research Council (2005) Guidelines for the Management of Asymptomatic Women with Screen-Detected Abnormalities recognises that for the most part, low grade abnormalities can be now be monitored and not referred immediately for colposcopy. This means that over time we will be seeing less Australian women referred for colposcopy. Thank you once more for sharing your opinion. We appreciate that everyone has different views on cervical screening, but we continue to promote the program because we believe it has real benefits for women.

From: Cancer Council Victoria, 15/04/2013

I think women want honesty, risk information and respect for informed consent. More women are working out they haven't been told the full story. This cancer is rare, 1% would get it with no screening, one third will still get it with testing (false negatives) but a whopping 77% of Aussie women are referred for colposcopy and usually a biopsy in their lifetime, almost all for false positives. (L Koutsky's research) The risks are high with this testing and the Aussie program is very bad as it over-screens which increases the risk of false positives for no additional benefit. When 99% of women will never have an issue with this cancer, more women are concerned about the biopsies and treatments that can damage the cervix and cause issues like infertility, miscarriages, more c-sections, premature babies, psych issues etc. Testing women under 25 is unsafe, unreliable, harmful and has no effect on the tiny death rate. (some say under 30) Finland has the lowest rates of cc in the world and sends the fewest women for biopsies, they offer just 5 to 7 tests - every 5 years from 30. As a low risk woman, my risk from this cancer is near zero, I'm not prepared to run the high risk of biopsies so a Dr can reach her target and pick up a nice cheque from the Govt. (I don't approve of these hidden payments either) I think women should be treated respectfully, given ALL of the information and left to make their own informed decision. It is never right or wrong to screen. Dr Raffle, UK screening expert tells us that 1000 women need regular smears for 35 years to save one woman from cc.(BMJ 2003) We all have the right to protect ourselves from harm, few women are currently giving informed consent and that's unacceptable. More and more I hear women questioning this program and the damage it causes to healthy women. Men got risk info very quickly with screening for common prostate cancer and there is respect for informed consent, women are denied these things for a rare cancer.

From: Debra, 15/04/2013

There are tests out there that wont compromise our modesty, but we can't have access to them. There is the CSA blood test, apparently it is more accurate than the pap smear. If the cancer council was really concerned about women who won't have smears because of modesty or cultural issues they would push to have that available. BTW these stories have not changed my mind about not having any more paps.

From: S, 15/04/2013

I am quite resentful of my experiences of pap smears. I went to the family planning clinic twenty odd years ago to ask for the pill. I was a virgin and but I was entering into a relationship. I was a shy person and was embarrassed enough already to ask for the pill. The nurse or doctor's first response was "you HAVE to have a pap smear." So there I was, forced into having one before I even had sex. Over the years looking back I have never actually been asked if I want one and I have never had pap smears explained to me. So when I had a had an abnormal reading once I assumed like a lot of women that I had early stage cancer. I don't don't why women are treated in such a paternalistic way when it comes to pap smears. I have been married for 15 years now and I have decided not to have any more as I resent the way the program has been implemented. There seems to be little acknowledgement until now what an invasive and embarrassing test it is and always the assumption that our modesty and dignity is not important.

From: s, 15/04/2013

I think it's great that here in Australia we have the opportunity to have pap smears, when in so many countries women don't. I agree that it should be 100% the woman's own choice but I personally will be booking my next test very soon (even if I don't particularly enjoy it!!)

From: SC, 15/04/2013

Eight years ago, my friend was lying on her couch, and felt a lump in her stomach. She saw her doctor, who told her that she had advanced cervical cancer. She was an amazing person, who stunned us all with the way she accepted her diagnosis and treatment with grace. She died three years ago, leaving behind a devastated husband and three adult children. She faced her death with as much dignity—and at times humour—as she could muster, but it’s fair to say that there wasn’t a lot of modesty at the end of that battle. When I get my regular pap tests (even after seven years of marriage!) I reflect on how my little bit of immodesty and uncomfortableness compares with her struggle, and I feel a sense of resolve to not only continue to get regular smears, but to remind my mum, my sister and my friends, how important it is. On a lighter note, just in the last hour, I’ve worried about: 1. Did I leave the iron on this morning? 2. What I’m going to wear to a 30th on Saturday? 3. Have I transferred money to cover my rent due today? 4. Do I have enough money to cover my rent today? 5. Have I paid the credit card bill? 6. If it’s Father’s Day in Australia, does that mean it’s Fathers Day in New Zealand? 7. Did I lock the door? 8. Did I lock my bike? 9. Is it going to rain on the way home? 10. Is my boss about to tell me off for the amount of time I spend on Facebook? Luckily, the last time I saw my doctor, she reminded me to take a pap test. One less thing to worry about.

From: S, 15/04/2013