Bec Gear, Cervical Cancer Survivor

COVID disruption leaves Australia’s cervical cancer goals hanging in the balance

Pre-pandemic Australia was on track to eliminate cervical cancer by 2035,1 but recent data indicates a sharp drop in the number of Cervical Screening Tests (CST) performed this year.

The Medicare Benefits Schedule (MBS)2 data indicates in March 2020, when COVID-19 restrictions began, testing numbers dropped to almost half the number performed the previous year.

Although test numbers were expected to drop this year with the program changing from a two-yearly to a five-yearly test, the number of women having their test is still much lower than anticipated3.

In November 2017, the National Cervical Screening Program (NCSP) changed to test for the Human Papillomavirus (HPV), a virus present in most cases of cervical cancer. This test allows for earlier detection of changes that could lead to cancer and so is recommended every five years.

The MBS data reveals that only 174,000 women had a CST from March 2020 to June 2020, when COVID-19 restrictions were in place. This figure is dwarfed by the half-a-million tests that were performed during the same period in 2019.

Adjunct Professor Annabelle Farnsworth, pathologist and Medical Director at Douglass Hanly Moir Pathology, and Director of Cytopathology and GynaePath, said;

“Nearly all cases of cervical cancer are caused by an infection with HPV. In most cases an HPV infection shows no symptoms and that is why regular screening tests are so important. Sadly, cervical cancer is a cancer of young women, so it’s vital that women have their tests from the age of 25. There is no doubt early detection saves lives. Australia was on track to eradicate cervical cancer by 2035 and we want to ensure we achieve that goal.”

“We expected a drop in testing this year due to the new program changeover, but at the beginning of the pandemic we saw a drop in pathology testing across the board, and we have not seen the numbers of CSTs increasing to show that missed tests are being rectified. We do not know when the pandemic will be over so it is important that people understand they cannot put their CST on hold indefinitely. Measures are in place to ensure people can catch up on their screening safely during the COVID-19 pandemic.”

A study by Cancer Council NSW4 predicted that disruptions due to COVID-19 would result in between 270,000 and 1,000,000 women missing a screening test in 2020.

Gold Coast mum Bec Gear (34) is a passionate advocate for cervical cancer awareness. She put off her CST for 12 months while in the process of moving back to Australia from New Zealand, and was later treated for cervical cancer;

Ms Gear said: “I was due for my test when living in New Zealand and I decided to wait until I was back in Australia. When I got back, I found other excuses to put it off but eventually a post I saw on social media prompted me to go and get tested. I was lucky that I caught the cancer at an early stage, I shudder to think how bad it could have been. It really worries me to see how many women have missed their CST this year. I understand that we are living in a pandemic, but cervical screening could save your life.”

“If you have never had a CST before or if you are overdue to have one, now is the time to catch up and get it done. Talk to the other women in your life about it too, that simple reminder could save someone you love.”

According to a recent study by the University of Melbourne5, the number of women aged 18 to 44 who needed to see a healthcare professional but chose not to has been on the increase.

At the beginning of June 2020, 18.3% of women in that age group who needed to see a healthcare professional chose not to. This rose to 20.2% in late June 2020, and further increased to 22.2% in August of this year.

This is a worrying trend and is also a missed opportunity for healthcare providers to remind women about cervical screening and check they are up to date.

Joe Tooma, CEO of the Australian Cervical Cancer Foundation (ACCF), said:

“In a normal year, around 46% of Australian women are not up to date with their cervical screening. We all know that 2020 has not been a normal year so that drop in screening has been amplified. Many people may not be aware that cervical cancer can affect younger people, we hear many stories like Bec’s from women in their twenties and thirties who have delayed their screening tests.

This is why cervical screening is offered between the ages of 25 and 74. Women in that age group who have not had a CST in the last two years are now overdue, so it’s time to catch up, make an appointment and get a CST.”

Image credit: Nigel Hallett / The Courier Mail

References

  1. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930183-X/fulltext
  2. http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=PN.0.22&qt=noteID&criteria=cervical%20screening
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845438/
  4. https://www.health.gov.au/resources/publications/modelled-analysis-of-hypothetical-impacts-of-covid-19-related-disruptions-to-the-national-cervical-screening-program
  5. https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0007/3478633/ri2020n23.pdf