WHAT else is wrong with our Health care system?

This article was published in The West End Times October 22, 2011.

According to the Public Health Agency of Canada 15% of women have never been screened for cervical cancer and 30% have not been screened in the last three years. Screening involves having a Pap smear. Of those who are screened each year in Canada, 400,000 women receive an abnormal Pap test result, 1,300 to 1,500 women are diagnosed with cervical cancer and almost 400 women die of this disease. The good news is that since 1996, the incidence of cervical cancer has declined and, since 1995, mortality rates have also decreased. The main reasons for these reductions are improved knowledge, the widespread regular use of Pap test screening, and the availability of HPV vaccination. The Pap test is an excellent way for women to prevent cervical cancer. It is the only way to detect abnormal cells in the cervix which, if left untreated, could develop into cancer.

The Federation of Medical Women of Canada (FMWC) and the Society of Obstetricians and Gynecologists of Canada (SOGC) are launching this year’s National Pap Test Campaign, to take place during National Cervical Cancer Awareness Week. This is the third year for this campaign, which originated as a main project of the FMWC in 2009. From October 23rd to 29th, over 250 health-care professionals across Canada are taking a stand against cervical cancer by hosting public Pap test clinics in their community. For a list of participating health-care professionals and clinics in the Montreal area go to the FMWC website at www.fmwc.ca, or call me. This campaign is to increase awareness across Canada with support from several groups. The hope is that by aligning timing with provinces and territories across Canada, the combined efforts will increase the reach and impact of their call to action for women to get their pap test (smear). Pap tests save lives!

Cervical cancer develops over time. The few minutes required for a Pap test could prevent hours, days, months or years in medical appointments, treatments, pain and suffering. Women are dying needlessly from this largely preventable cancer. Dr. Nahid Azad, President of the Federation of Medical Women of Canada, is concerned about the women who are not getting screened. “Women can beat the odds. Why “roll the dice” when Pap testing is free, quick and effective? As this year’s campaign theme states it so well – Don’t count on luck to save you from cervical cancer. Instead, place your bets on your family physician, gynaecologist, or registered nurse to provide you with your Pap test today.” (FMWC Press Release: Oct. 12th 2011)

The bad news is it seems to be getting harder to have a Pap smear. Many GP’s no longer do them and refer to specialists and then there’s the WAIT!!! These free clinics are a great way to increase awareness and for some women to take advantage of the offer. However, we need to recognize the problem and find long term solutions for the many women not getting screened. In the “North”, nurses do Pap smears. The question is “Are nurses smarter in the North?” or is it that solutions have been found out of necessity? When spreading the word about this campaign many women said that the hours are limited and it is difficult to get there and they questioned how long the wait would be given that there is walk-in testing. At least this campaign reminds us of the importance and may urge women to get tested if they have a doctor. What about the many women who do not have a doctor? How do they get an appointment for this test? Do women have to get an appointment with their GP just to get a referral to a doctor who does Pap smears? This long process bogs down the system one more time. While I applaud the efforts of the health professionals who are donating their time to offer the free Pap Smears to people who are not their patients and the efforts of those conducting the campaign, can we not start the discussion about long term solutions? I am concerned that as our health care system continues to break down access to this test will decrease. Why can’t we have Pap smear clinics? Why can’t nurses be more involved? Why can’t we speed up the process with automatic referrals based on best practice guidelines? Why can’t we???