It will be recognizable for many women in their 30s: yes, you think cervical cancer research is important, but you still don’t make that appointment. The letter with an invitation for a smear disappears in the big pile.
In 2020, almost 50 percent of the invited women took part in the population screening. In the three years before that, this was an average of 57 percent. A preliminary stage of cervical cancer was found in more than 3,400 women (1.2 percent). HPV was found in about 10 percent, which is the virus that can cause cervical cancer.
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Busy thirty-somethings
It must be said, the numbers are slightly distorted by the corona pandemic. Sometimes GPs were so busy that women were asked to come by at a later time for the smear if possible. Some have done so.
But whether it is corona or not, young women in their thirties in particular do not participate much in the population screening, the RIVM has noticed.
“It is a hectic time for many women of that age,” says Sandra van Dijk, who is responsible for the cervical cancer population screening at RIVM. “Because they have young children, for example, or are busy with work and their social life. What happens a lot: women receive an invitation when they are pregnant and then forget to make an appointment when they have given birth.”
‘They don’t know anyone with that cancer’
Low risk awareness, as it is called, also plays a role. “They usually don’t know anyone their age with cervical cancer. Cancer is often far away from them, is something of the elderly. Or they have somewhere – wrongly – received that it is something hereditary.”
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RIVM is now trying to reach young women in several ways. Van Dijk: “We are testing a pre-announcement. Women receive a letter a few weeks before their thirtieth birthday. The message: talk about it with friends, your mother or sister, because you will soon receive an invitation for the population screening.”
That letter will probably be sent from April. In addition, an attempt was made to use simpler language in the invitation and it contains a QR code that leads to a website with videos in multiple languages. “We will also make these for 30-year-olds,” says Sandra van Dijk, “about participating for the first time.”
Make your own smear
Send all women a self-test for cervical cancer, advised the Health Council last year. Then hopefully the women who find the smear annoying or who do not have the time to go to the doctor will also participate. With a self-test you take a sample yourself and send it to the laboratory by post. There it is tested for HPV.
That standard home test is coming. At the end of December, the State Secretary for Health agreed with the advice. RIVM is now considering how this can best be arranged. On the one hand, waste of plastic must be prevented and, on the other hand, participation must be as easy as possible.
In the course of 2023, the home tests will be sent as standard. Until then, you can request such a home test yourself.
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Van Dijk of the RIVM thinks it is sensible that the smear at the doctor’s office is not completely replaced by the self-test. “The self-sampling kit is a good alternative, but only tests for HPV. If you have the virus – which happens to 10 percent of women every year – then you still have to have a smear done at the doctor. That smear tests for HPV and if necessary also immediately on troubled cells, which may be a preliminary stage of cervical cancer. After that you can be referred to the gynaecologist.”
2023 is also the year that the first women receive a call who have been vaccinated against HPV as a girl. That vaccine has been part of the childhood vaccination program since 2009. An important moment, because it will be the first time in the Netherlands that it will be possible to measure whether their risk of cervical cancer is indeed much smaller. Foreign research shows that already.
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80 percent will be infected with HPV at some point
- Cervical cancer develops very slowly and is almost always caused by a long-term infection with the Human Papilloma Virus (HPV), which 80 percent of people become infected with during their lifetime.
- The virus can be transmitted through any sexual contact, including skin to skin.
- Boys and men can also get the HPV virus.
- Usually the body clears the virus within two years, but long-term infection increases the risk of cervical cancer or, for example, labia cancer, anus cancer or throat cancer.
- HPV vaccination for girls and (since this year also) boys can prevent such an HPV infection largely occur.
- Women between the ages of 30 and 60 are invited to have a Pap smear every five years. The doctor’s assistant does a brush through a duck’s mouth and get some cells from the neck of your uterus.
- With that population screening (that is, that smear) early stages of cervical cancer can be detected. A preliminary stage of cervical cancer is usually treatable. Cervical cancer can be prevented by treatment.
Source: Foundation Olive in RIVM
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