Act before the storm comes …
There are things that cannot be overemphasised, such as the important role of mothers for example. Mothers do not only give lives, they nurture, they care for and look after their children for a lifetime. They do all this besides their jobs, besides being wives and mothers, tasks, that are truly, not easy to juggle. Mothers have the wonderful, amazing ability to look after a myriad of things at the same time, but sadly, often forget to take care of themselves.
The incidence of cervical cancer increases significantly from the age of 25 years. Actually, cervical cancer is the most common cause of death of middle-aged women. An estimated 570.000 women are diagnosed with cervical cancer worldwide and about 311.000 women, mothers and wives die from the disease annually. There is a significant, 50-fold difference among regions of the world regarding mortality rates, although, this type of cancer is preventable. Let me mention Finland as an example where cervical cancer mortality per 100 000 of the population is 1 . At the time of diagnosis the average age of women is 53 and only 59 at the time of death, which further highlights the severity of the problem, the significance of early mortality related to cervical cancer as a global public health concern.
What can we do to fight this high-mortality cancer? Early diagnosis and effective screening are crucial. Although Hungary provides both, 400 women lose their lives due to cervical cancer every year.
Complex screening programme (including colonoscopy and cervical smear test) was introduced in Hungary in the 80s and oncological screening has been a mandatory part of gynaecological consultations for women aged 25-65, repeated every three years if the test results are negative. The sad fact is, that the number of women dying from cervical cancer is stagnating in Hungary, there has not been any considerable decrease. Mortality risk related to cervical cancer among women aged 25-64 years is currently 3.1 times higher than in EU-15 countries. Cervical cancer screening introduced decades ago has not had the impact that was expected. The reason, apparently, is low participation rate.
In Western-European cervical cancer screening models, screening is integrated into primary care, thus gynaecology specialists only check cases that are potentially non-negative. In 2009, Hungary introduced the Health Visitors' Cervical Cancer Screening Program which was continued through the following years. Results showed that cervical screening performed by health visitors was effective and did improve access to screening for the population.
We should bare in mind, how important effective communication is if we want to maximise participation rates. Surveys have revealed that the majority of those that did not attend screenings were lower educated and were unaware of the importance of prevention measures.
The human papilloma virus (HPV )is the most important risk factor in the development of cervical cancer. It enters the body through sexual contact and may not cause symptoms for years or even decades. During this time it may cause changes within the cells of the cervix that are cytologically detectable, and the pathological process can be halted without causing further complications. Consequently, it is crucial to inform those of the population that are at potential risk about the importance of attending screenings before symptoms develop. Risk factors include frequent changes of sexual partners, early sex life and recurrent vaginal infections. Warning signs may include painful intercourse, spotting bleeding and foul-smelling, yellowish vaginal discharge.
Health awareness should be introduced, developed and facilitated as early as possible. It is of pivotal importance to emphasise the value of health, of being healthy and of maintaning health at every age and in every forum or scene of life. It is the duty of all of us to look after and take care of ourselves and members of our families. Don’t forget, screening can save lives.
Mothers’ Day shall be one of the nicest and happiest of holidays if we manage to decrease the current number of 400 deaths down to zero.
Dr. Zsuzsanna Orsós , university assisstant lecturer
Department of Public Health Medicine
Dr. Döbrőssy Lajos: A méhnyakrákszűrés öt évtizede Magyarországon. Nőgyógyászati Onkológia 2007; 12:5–9.