Eulalee Thompson, Health Co-ordinator
STORIES COLLECTED by researchers at the Pan American Health Organisation (PAHO) from real women living in the Caribbean about their personal experiences with Pap smears and cervical cancer diagnoses, point to a dearth of knowledge on the subject, inadequate health care facilities and needless suffering.
The suffering can be described as needless because cervical cancer diagnoses and mortality, though high in the Caribbean region, is highly preventable.
"If we can screen, we can get to curable," Dr. Glenda Maynard, PAHO's chronic disease and mental health adviser, last week told health professionals and journalists attending the Caribbean symposium on media and health in Antigua & Barbuda.
Screening is a problem in the region because many women are not aware of the screening test the Pap smear and in some countries the technology and skill for performing and accurately reading test results are inadequate or non-existent. Dr. Anthony Pottinger, gynaecological oncologist, practising in Trinidad and Tobago, said that the region is currently screening only between 10 and 15 per cent of the at risk group and that the immediate target is to screen 80 per cent of the at risk group.
Some women in the Eastern Caribbean upon diagnosis with cervical cancer are made to travel to other Caribbean countries such as Trinidad or Barbados for treatment, as the necessary radiation therapy and other treatment are not available in their own countries. One woman, Mitzy, recounts her humiliating experience with an immigration officer as she endured his 'torturous questions" when she travelled away from home for treatment.
"He just tapped a pen on the desk for the next 10 minutes. He would look at me, then look down and then look at the paper on his desk...just tapping. He didn't know that all the while I was bleeding," Mitzy said.
Mitzy's wish is that governments would invest in adequate gynaecological care in the region to make women's experience with the big 'C' far less distressing.
In the last 40 years, according to PAHO/WHO, cervical cancer mortality and incidence rates in Latin America and the Caribbean have not declined as significantly as in North America. The worldwide figures for cervical cancer incidence and mortality in 2000, were annually estimated at 470,606 and 233,372 respectively. More than 80 per cent of these cases will occur in developing countries. Furthermore, it is estimated that more than 80 per cent of the nearly 38,000 cancer deaths and 93,000 cervical cancer cases in the Americas, occur in Latin America and the Caribbean.
HUMAN PAPILLOMAVIRUSES
Various studies have provided scientists with evidence that some genetic types of the human papillomaviruses (HPV) are the main causes of cervical cancer. The viruses are passed on during sexual intercourse. Scientists note that contracting some variants of the HPV puts women more at risk for developing cervical cancer. Many studies have also identified HPV-16 and HPV-18 (two variants of HPV) as present in cervical cancer among Latin American and Caribbean women.
Individuals who start sexual activity at an early age and engage in multiple, unprotected sexual encounters are usually at higher risk for contracting these viruses.
However, Dr. Pottinger said that condoms only provide partial protection from HPV as the viruses can exit through most of the ano-genital regions.
You can send your comments to eulalee.thompson@gleanerjm.com.
