Is $1.5 million worth it for the risk of cancer?
That's the question being asked by hundreds of Ontario women, who are protesting the recent decision by the provincial government to change guidelines surrounding Pap tests, which screen for cervical cancer, to once every three years, as opposed to annual checks.
According to a petition on Change.org:
In the span of three years it is possible for a woman's cervix to develop abnormal and even cancerous cells. Further, our Government will not even allow a woman to PAY for a pap smear if the government still chooses to limit its funding. Our tests will be DENIED processing. That means that as Canadian women, we are being DENIED our right to healthcare.
As City News reports, the province has changed its Cancer Care policies with an eye toward cutting costs, with fewer tests initially saving $1.5 million for 2012/13 and $6.1 million for 2013/14.
For women who wish to pay for the test, however, those who created Change.org's petition may not be entirely incorrect in their statements — for example, LifeLabs, a laboratory testing service in Ontario, British Columbia and Quebec, offers an HPV test that looks for the potentially cancer-causing virus (versus a pap test, which looks for abnormal cells). This test can be obtained for a fee, or potentially covered by insurance.
Guidelines issued by the Canadian Task Force on Preventative Health in December 2012 are what sparked the switch, with the additional stipulation of changing the tests from occurring at age 21 to starting at age 25. As Dr. James Dickinson, a professor of family medicine at the University of Calgary, stated, "Doing it every year doesn't really add very much (protection) but it adds a lot of inconvenience and some harm," as reported in The Canadian Press.
The concern for over-testing revolves around finding cells or lesions that will not turn cancerous, but will require procedures that could permanently impact the cervix and potentially affect a woman's fertility and ability to carry a child, according to the CDC.
The Society of Obstetricians and Gynecologists of Canada (SOGC), meanwhile, has taken issue with waiting until age 25 for the test, with CEO Dr. Jennifer Blake noting that abnormal cells can be found in younger women, and therefore impacting "the natural history of the disease."
A Pap test can help detect cancerous cells early, and as with any cancer, the sooner it is found, the better the chances of survival, says the Canadian Cancer Society. The Human Papillomavirus (HPV) vaccine, which is approved for women between 9 and 45 years of age, and found to be most effective when given between 9 and 13 years of age, can also help prevent cervical cancer, and its prevalence in Canada is undoubtedly linked to these changes in policy.
As it currently stands, women in Ontario can expect a Pap test every three years, from the age of 25 to 69. But if a test shows abnormal results, says Cancer Care Ontario, her screening plan will change in order to monitor the cells for a short time after.
Also on HuffPost:
The founder of Liz Lange Maternity is now a <a href="http://www.huffingtonpost.com/liz-lange/cervical-cancer-the-silent-killer-of-women-in-the-developing-world_b_1655231.html">vocal spokesperson for cervical cancer awareness</a> after her own 2001 diagnosis. <a href="http://www.health.com/health/article/0,,20411629,00.html">"The diagnosis terrified me,"</a> she told Health.com: <blockquote>I had a 2-and-a-half-year-old and an 8-month-old baby, and I was working on a fashion show and launching a new product line. On a personal level, I was afraid that I wouldn’t be there for my children; professionally, I was afraid that if people knew about my diagnosis, they would think of me as sick and be uncomfortable doing business with my company. It was so upsetting that any time I talked about it I burst into tears. I kept silent about it for a long time."</blockquote> After a hysterectomy, chemotherapy and radiation, Lange has been cancer-free. "Now I feel absolutely compelled to tell my story, because it really shows how it can happen to anyone," she told the website.
The actress reportedly <a href="http://newsone.com/2015287/yvette-wilson-cancer/">faced mounting medical bills</a> for both cervical cancer and kidney disease before ultimately <a href="http://www.huffingtonpost.com/2012/06/15/yvette-wilson-star-of-moe_n_1600037.html">losing her battle with stage 4 cervical cancer in 2012</a>. African-American women are <a href="http://www.cdc.gov/cancer/cervical/statistics/race.htm">most likely to die from the disease</a>, compared to women of other races and ethnicities, according to 2008 data from the CDC, possibly because black women seem to have <a href="http://www.huffingtonpost.com/2012/06/15/yvette-wilson-star-of-moe_n_1600037.html">more trouble clearing HPV</a>, which usually goes away on its own within a year or so.
In 2012, the beloved author shared in a blog post that she had recently been <a href="http://www.people.com/people/article/0,,20627052,00.html">diagnosed with breast cancer</a>. But, deeper into her post, she also revealed she had a hysterectomy 17 years earlier because of cervical cancer (caused by HPV). "No other treatment necessary," she wrote on her blog: <blockquote>Another story for another time. If I had a young daughter or son I'd talk to their docs about having the vaccine to protect them from getting or giving HPV. If only there was a vaccine to protect us from breast cancer we'd be lined up -- wouldn't we?</blockquote>
In 2001, the actress was <a href="http://www.people.com/people/article/0,,20196314,00.html">diagnosed with cervical cancer</a> after a Pap test, People reported. She opted for a hysterectomy, but doctors were able to preserve her ovaries, allowing her to <a href="http://www.people.com/people/article/0,,20445749,00.html">welcome son Zev in 2008 via a surrogate</a>. "<a href="http://www.people.com/people/article/0,,20009915,00.html">I woke up after the surgery</a>, and I asked what they took out," she told People in 2007. <blockquote>They didn't know what they would find beforehand. But it was just my uterus. I had my ovaries, and I didn't have to go through chemo. I thought, "Okay, now the cancer is gone. Let's get going." My doctors gave me the all clear, and I moved to New York City in January 2002. It was the best time of my life.</blockquote>
The 27-year-old British reality TV star <a href="http://www.huffingtonpost.co.uk/2012/03/19/jade-goody-cervical-cancer-women-smear-tests_n_1361915.html">died from cervical cancer at the age of 27</a>, after publicly documenting her battle with the disease. Some questioned how the disease progressed in someone so young, and Goody admitted to <a href="http://news.health.com/2009/04/06/jade-goody-cervical-cancer/">ignoring doctors' urges for follow-up care</a>, Health.com reported. Still, her openness and honesty about treatment did raise awareness for prevention. Experts noted <a href="http://www.huffingtonpost.co.uk/2012/03/19/jade-goody-cervical-cancer-women-smear-tests_n_1361915.html">spikes in the number of young women making appointments for Pap tests</a> shortly after her death, HuffPost UK reported.
The former first lady of Argentina, more commonly known as Evita, was <a href="http://www.nytimes.com/2011/12/20/health/report-on-eva-peron-recalls-time-when-lobotomy-was-embraced.html">diagnosed with advanced cervical cancer</a> in August 1951, according to an essay in <em>The New York Times</em>. At the time, it was common to keep the patient in the dark about her true condition, so Peron was told she had a uterine problem and then operated on in secrecy. (The doctor entered the room only after she was under anesthesia.) Radiation and chemotherapy (and a lobotomy "for the pain") followed, but she grew sicker, until dying from the disease in 1952 at the age of 33.
This "Real Housewife" of Orange County appeared on an episode of the "Dr. Oz" show and <a href="http://www.people.com/people/article/0,,20585473,00.html">revealed she had been diagnosed with cervical cancer</a> in 2012. "I go to the doctor and I have lumps in my breasts and I had cervical cancer that had to be removed... <a href="http://www.bravotv.com/blogs/the-dish/tamra-barney-on-her-cervical-cancer-scareyvette">I'm talking to my doctor about... doing a hysterectomy</a>," she said.