Cervical cancer is not that common in Canada, and that’s a good thing.
It is detected early and treated properly. Vaccination is accepted. Last year, it was estimated that 1,450 Canadians would be diagnosed with cervical cancer and about 380 would die from it.
But these kinds of numbers mean several things. There are misconceptions, lingering stigmas, and even a medical community that is gaining less and less practical experience with patients with invasive cervical cancer.
For example, my gynecologist can count her current cervical cancer patients on one hand, and we vary in age. Fortunately, he is very knowledgeable about cervical and other gynecological cancers, and the damage caused by disease and treatment to a body.
When he diagnosed me in an emergency room, I sighed with relief. He sighed for another reason. He had already seen my near future in other patients.
January is Cervical Cancer Awareness Month worldwide. When I was diagnosed with an invasive case in 2018, I immediately began a personal crusade to speak publicly about the problem.
About a year later, I was invited by the International Union Against Cancer to speak in Vancouver at an international conference called Women Deliver. It was there that I learned that the World Health Organization had set a goal of eradicating cervical cancer by the end of this century, with a goal of 2030.
The International Agency for Research on Cancer (IARC) states that to eliminate cervical cancer as a public health problem by 2100, all countries must reach and maintain an incidence rate of less than four new cases of cervical cancer per 100,000 women per year.
Measurement targets for 2030 include 90% of all girls being fully immunized with an HPV vaccine by age 15, 70% of women being screened using a high performance test at the age of 35, and again at the age of 45, that 90% of women with pre-cancer are treated and 90% of women with invasive cancer are supported.
We only have seven years left.
In the four and a half years since my diagnosis, I have watched new American and international friends online progress with their illness and die, battling with their insurers. At Women Deliver, I heard stories of women “sent home to die in church praying”.
I had no idea. But I also didn’t know that missing a Pap test could lead to months of cancer treatment and lifelong health problems.
Although Canada’s numbers are improving, they are not so rosy around the world. In 2020, about 604,000 women were diagnosed and about 342,000 of them died from the disease. Unsurprisingly, most of these cases and deaths (about 90% for both) occurred in low- and middle-income countries.
And that’s largely due to cultural norms in countries where women don’t tell their male doctors about things like menstrual bleeding or pain. In some places, there are simply no medical personnel. In others, there is a lack of information.
This makes the eradication of this disease an ambitious goal. And because Canadian women are so well cared for and often caught at such an early stage that we may not even talk about it, cervical cancer can often go unnoticed as a problem.
It certainly didn’t seem important to me, until it was.
When I was a teenager, I was told that cervical cancer was something only women with promiscuous morals got. So the longer I was married, the less I worried about this problem.
It is impossible to know when I contracted HPV. It can lie dormant (and undetectable) for decades, then begin to grow when your immune system is down. It’s impossible to know when this happened to me because it’s such a slow growing cancer (usually). It was between that last Pap test and when my symptoms started a few years later.
And honestly, none of that matters. There is no blame to assign, no villain in this story. But there are heroes. It is the doctors who keep themselves informed about cervical and other gynecological cancers and their symptoms. It is researchers who are finding new ways to eradicate this terrible disease.
And it is women, as well as transgender and non-binary people, who are fighting for their health care, here and around the world.
To learn more about cervical cancer, visit cancer.ca.
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