Young women too complacent on cervical screening

"cancer" written in letterpress blocks

Young women are worryingly complacent about cervical cancer screening, says Cancer Council Victoria – so the organisation is set to remind them of its importance.

A campaign launching in Victoria this week will remind women overdue for their two-yearly Pap test that no matter how awkward, cervical screening provides peace of mind. About half of young Victorian women aren’t having Pap tests every two years, despite knowing they should.

The latest statistics show that only 52% of Victorian women aged 25 to 29 years are having two-yearly Pap tests, which is below the Victorian average of 60.4%.

PapScreen manager Hiranthi Perera says the campaign is vital to ensure that women do not delay screening, ahead of major changes to the National Cervical Screening Program due in mid-2017.

“Our research shows that many young Victorian women are complacent about their cervical screening,” says Perera.

“While most of these women know they need regular Pap tests, even if they have had the HPV vaccine, only half of these women continue to screen.”

In Victoria, 83% of women diagnosed with cervical cancer have either never had a Pap test or did not have them regularly before diagnosis.

Young women aged 25 to 29 who have had the HPV vaccine are screening 13% less for cervical cancer than unvaccinated women. Only 45.2% of HPV-vaccinated women participate in regular screening versus 58.7% of unvaccinated women of the same age.

While the HPV vaccine protects against the two HPV types that cause around 70% of cervical cancers, it does not protect against all cancer-causing HPV types.

“The vast majority of Pap test results are normal, so for peace of mind about your health, book a Pap test if you are due,” Perera encourages women.

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1 Comment

  1. Elizabeth Eb

    I think more women have made an informed decision not to screen or not to screen as often or have found something better. The world is getting smaller and more women have discovered that other countries have very different programs, with better results. Our program has not followed the evidence for many years, continuing with excessive and early testing, both mean a LOT more false positive results, excess colposcopy/biopsies and over-treatment FOR no additional benefit to women.
    I’ve watched the Finns and Dutch for years, they’ve put women first and followed the evidence. The Dutch and Finns have offered 7 pap tests, 5 yearly from 30 to 60, for many years, the Finns started their program in the 1960s, they have the lowest rates of cc in the world and refer FAR fewer women for biopsies and treatments. We “treat” more than 10 times the number of women, many of them young.
    Young women produce a lot of false positive and sadly, no country has shown a benefit doing pap testing on those under 30, these very rare cases occur whether you screen or not.
    I don’t understand why the approach used in Australia is so different, we get a screening “story” rather than real and complete information and the focus is on numbers, the target. This is unethical and possibly more, the law says informed consent is a requirement for all cancer screening. Yet it seems to me this is denied to women in this country and even consent itself is often missing. (the Pill has nothing to do with pap testing, cancer screening is always a choice, to reject or accept as you see fit) Our GPs even receive target payments for pap testing, but this potential conflict of interest has never been mentioned to women.

    The Dutch will shortly scrap population pap testing, a cruel burden for the VAST majority of women who can never benefit, but can be harmed by false positives and over-treatment. The Dutch will offer 5 HPV primary tests or HPV self-testing at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV+ will be offered a 5 yearly pap test. Most women are HPV- and having unnecessary pap tests.

    The changes to our program are long overdue, but once again, will side with excess and once again, ignore the evidence. You only need to do basic research to discover HPV primary testing is NOT a good idea before age 30, about 40% WILL test HPV+, transient and harmless infections that will clear naturally in a year or so. Needless to say, our program will start at age 25, not a decision backed by the evidence.
    We’ll also, test too often, 5 tests in total is enough. Also, HPV+ women should simply be offered a pap test, not dashed off for colposcopy and biopsy. HPV self-testing will also, be denied to Aussie women until they reject the invasive HPV test (like a pap test) for 6 years, this is unacceptable, all women should have the option of self-testing if they prefer it. Note: you can buy HPV self-testing kits online and even request one through your GP. (but you’ll have to pay for it) You’ll have to stand firm though…this option is being kept very quiet.
    HPV- women who are no longer sexually active might choose to stop all further testing. (doubt they’ll get that option under our program, HPV testing will be recommended until an absurd 72 or 74)
    Needless to say I’ve never taken part in the Aussie program and never will, my health is more important. I know HPV- women cannot benefit from pap testing and years ago, before the significance of HPV was clear, the numbers didn’t work for me. 0.65% lifetime risk of cc or 77% lifetime risk of colposcopy/biopsy under our program, no deal, far too much risk for me, so I’ve always declined, content with my near zero risk of cc. (now I know HPV- women cannot benefit from pap testing and that’s MOST women)
    I’d urge all women to take the time to do some research and make informed decisions about screening and yes, we can say no. It should be a disgrace that women are treated this way with little respect for informed consent and consent itself is often missing as well. It says to me the medical profession and others still view women very differently; others do not have the right to make screening decisions for us or accept risk on our behalf!
    Even at this late stage, Papscreen and others are still urging women to continue with early screening and serious over-screening. In my opinion, and the evidence supports me, urging women to screen early and to seriously over-screen is bad medical advice.
    HPV Today, Edition 24, is worth a read, it outlines the new Dutch program.
    The Nordic Cochrane Institute produced an excellent summary of the evidence for and against breast screening over ten years ago, it’s a must-read for any woman thinking about screening. (go to their website) I’ve also, declined breast screening. About 50% of screen detected breast cancers are over-diagnosed and any benefit of screening is wiped away by those who die from heart attacks and cancers after treatments so the risks of screening may exceed any benefit.
    Screen or don’t screen but make it an informed decision.
    I think more women are getting to the evidence and making informed decisions about screening.

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