Pap smear can save lives

The screening can detect early signs of cervical cancer 

Awareness: Despite being a curable disease, cervical cancer is the most common cancer among Bhutanese women even today.

This is attributed to late diagnosis, which is caused by women not turning up for screening or pap smear although the service is availed free of cost from almost all health centres.

According to gynaecologist Dr Ugyen Tshomo, about 400 cases were diagnosed in the last seven years, from 2008 to 2014. Out of that, 135 have succumbed to the disease. Trashigang, Thimphu and Wangduephodrang have the highest number of cases and deaths.

Yesterday in Kabisa, Punakha, where the World Cervical Cancer day was observed, about 300 women turned up for screening and Pap smear, conducted as a part to raise awareness among women. November is the cervical cancer month.

Doctor Ugyen Tshomo said Kabisa was chosen because it has a high rate of women suffering from cervical cancer in the Punakha region. In 2013, two women from Serigang and Betikha of Kabisa gewog died from the cervical cancer, said Kabisa BHU’s health assistant, Bhawani Shankar.

The death rate is high and indicates late diagnosis and treatment, according to Dr Ugyen Tshomo. “More than 50 percent of women diagnosed with cervical cancers were younger than 50 years. Therefore, it kills women while they are still socially productive and their children are dependent on them,” she said.

The gynaecologists warned that unless 70 percent of women in the target age group of 25-65 years come forward for Pap smear, cervical cancer will continue to kill our women.  “Poor coverage by screening is the main reason for cervical cancer being common in Bhutan.”

Stressing on the importance of prevention, the gynaecologist said that even if diagnosed at an early stage, it could be cured with treatment. “This must be understood by policy makers, politicians, programme managers and the public.”

A recent health survey showed coverage of about 50 percent in urban areas and 40 percent in rural areas. During a study in 2012, it was found that even in Thimphu only 60 percent of women have ever undergone Pap smear. This, the gynaecologist attributed to lack of awareness. Even educated women believe that Pap smear is done only if they are availing other services like antenatal care or family planning. Women without children and those that have completed family think Pap smear is not for them,” she said.

While there is cure for early detection of cervical cancer, doctors said radiation treatment could cure late detection of the cancer.

Meanwhile, 88 women were screened at Kabisa yesterday. Pem Zom, 62, was diagnosed with the cancer in 2008. She underwent radiation treatment in Siluguri and has now recovered. Her neighbour, Phub Zam, 37, a mother of three said she was too shy to do Pap smear although she was aware of it. “She came for the Pap smear hearing that a female staff would be conducting it,” she said.

Women feel that the sex of the health staff mattered when availing the service. Kinley Dem, 43, said a group of village women had their last pap smear when the BHU had a female staff.  “Villagers feel uncomfortable when a male is doing the Pap smear,’ She said.

Cervical cancer is the fourth most common cancer in women worldwide, 70 percent occurring in developing countries due to lack of screening. It is the most common cancer in women in 39 countries and most common cause of cancer deaths in 45 countries.

By Dawa Gyelmo

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