Cervical cancer continues to be the most common cancer in women in Bhutan with an estimated incidence of 20/100,000 women. And because more than half the cases are diagnosed when the cancer is already at a matured stage, mortality rate ensuing from the illness is high.
Bhutan has come a long way in terms of development in the health sector and to keep ourselves abreast of the latest technology and medical know-how has been the top national priority. That, however, does not mean that we have the privilege to full sail as if the matters are all well in hand.
The reality is that even as there has been a remarkable improvement in our health system, lack of expertise and commitment has given rise to intermittent gaps that threaten to leave the entire system out of order.
A significant challenge with the cancer that is most prevalent among the Bhutanese women is that there is today a formidable—almost physical—barrier that needs to be torn down. And that must begin with what seems to have been in short supply all the while—education.
Experience, largely from the global perspective, has shown that women do not consider Pap smear or cervical screening a priority because of poorer understanding of the risks and the role of screening in cancer prevention and detection.
Although cost and access to service are not in any way the deterrents in Bhutan, embarrassment, pain or discomfort on the part of service seekers are the major barriers. Worst of all—the fear of result.
In such a scenario, much of the work needs to be done by the health professionals. If our women do not understand the risks associated with ignoring cervical screening, information and education materials are vital to allay fear and inspire willingness to avail themselves of the screening services. A woman said that she was willing to have Pap smear or cervical screening if a health practitioner told her that it was important.
But, perhaps more important, is to provide a comfortable and secure environment for screening. According to the global trend, three out of four women who develop cervical cancer have either never had a Pap smear or haven’t had one in the past five years.
Thirteen years after the screening programme began in Bhutan, our national coverage is less than 60 percent. Health minister has made clear that this is not enough,which means we have a lot more to do.
And we cannot make a short work of it.