Earlier sexual activity means earlier cervical cancer screening – doctor

The change in behaviours among Vincentian women, leading to having sexual intercourse at a younger age, has prompted local medical experts to call for earlier screening for cervical cancer.

In 2023, the country recorded 12 cervical cancer deaths, making the illness the second-ranked cancer-causing deaths behind breast cancer.

International guidelines recommend that women begin screening for cervical cancer at age 21, however Senior Registrar and General Surgeon at the Milton Cato Memorial Hospital, Dr Erica Jordan said if St Vincent and the Grenadines (SVG) is to lower the number of cervical cancer deaths, screening recommendations should be adjusted to at least one to two years after the start of sexual activity.

“International guidelines would tell you at 21 years … the culture and the world is changing, the average onset of sexual relations is getting earlier and earlier, we have to start screening earlier and earlier if we are going to win this war against cervical cancer,” she stressed on a recent VC3 Round table discussion.

“Do not wait until 21, from two years after you start your sexually-active lifestyle, you start to screen for cervical cancer.”

OBGYN and Gynaecologist Oncologist, Dr Damaris Baptiste identified the “main culprit” leading to cervical cancer as the Human Papillomavirus (HPV), with about nine high-risk strains that account for cervical cancer. She added that the HPV virus is usually cleared from a person’s system by age 30.

Dr Baptiste said the time it takes to progress to cancer is varied, with medical literature showing that in some cases it can take ten to twenty years.

However, she highlighted that for SVG this may not always be the case.

“… in St Vincent and the Grenadines we have done a study to guide us as to what types of DNA strands are in our population. We have found that we have extremely high-risk strains of HPV in our population and we have seen individuals in their twenties, as young as 22, we have heard of cases in their late teen years being diagnosed with cervical cancer,” she noted.

“We have even had individuals in St Vincent and the Grenadines who would say ‘I just had a pap smear two years ago and now you are telling me I have cancer’? So it means the general recommendations and international standards that says you can have a pap smear every three years may not be applicable to our population here in St Vincent.”

The high-risk strains of the HPV virus found in SVG, earlier sexual activity as well as other risk factors such as smoking, a compromised immune system , contracting sexually transmitted infections and multiple full-term pregnancies means that screenings for women must be done earlier and consistently, she stressed.

In SVG, pap smears in the public health system are done at a cost of EC$55 and Dr Baptiste admitted that the cost factor could act as a deterrent for regular screenings.

“It may very well be a prohibitive factor and our Ministry is aware of this. They are doing everything in their power to try to make it free, but of course we have to think about the economic factor. I believe that it may come on stream where it can be free of costs in our lab at the Milton Cato Memorial Hospital.”

The month of January is observed as Cervical Cancer Awareness Month and for this year it is being observed under the theme ‘Learn, Prevent, Screen’.