Dr Vanessa Harry, senior lecturer and head of the Obstetrics and Gynaecology Unit at the Faculty of Medical Sciences at UWI, St Augustine, says TT has about 200 cases of cervical cancer a year, and most of those cases present at stage 2 or 3 because there are no symptoms during stage 1.
She said many of those women either skipped their Pap smears or never had one and only went to the doctor when they noticed something was wrong.
Harry believed that TT needed a national screening programme. The programme would invite women to have their first Pap smear at 20 and remind them, either electronically or through the post when their next one was due.
She pointed out that an abnormal Pap smear did not automatically mean cancer. It meant there were abnormal cells that may be easily treated and removed, preventing cancer from developing in the future.
“Currently, in TT, screening is opportunistic. If you know about it, or you heard about it somewhere, you just go and do it. And then you might forget about it and you don't do it again for another ten years. It's very haphazard and very sporadic.
“If you wait for people to turn up and do a test, the majority will not. It's estimated the coverage for Trinidad for screening tests is probably less than ten per cent of the population that needs it.
“The coverage is probably less than that when it comes to Pap smears because people view Pap smears as, and it is a very intimate test. They are scared of it and embarrassed. They prefer to not even think about it, much less do it.”
However, Harry said there were newer ways to screen for cervical cancer, such as the liquid-based cytology test – a cervical cancer screening test which was introduced in the mid-1990s.
It involves collecting cells in a liquid instead of directly on a slide. It can separate blood and other materials that might make it difficult to interpret the sample and allow for additional testing, such as for human papillomavirus (HPV).
HPV is a viral infection with more than 100 varieties. It is a DNA virus that people primarily get through skin-to-skin and sexual contact. The infection usually shows no symptoms and goes away by itself, but some types can cause genital warts or certain cancers, including cervical cancer.
Harry said another medical advancement was HPV testing. She said, in the 1940s, it was discovered over 90 per cent of cervical cancer was caused by HPV.
“When we discovered how to do HPV testing scientists thought, ‘If we know what's causing cervical cancer, why can't we prevent it?’ And they developed the vaccine, which is the first ever anti-cancer vaccine, and it is highly effective.”
She recalled working in Scotland, which pioneered the early trials of the vaccine in the UK. She said the country was vaccinating its boys and girls around age 12 before they were exposed to sex and HPV.
Since the programme started in Scotland in 2008, no cervical cancer cases were detected in fully vaccinated women up to January 2024.
She said the HPV vaccine was on local childhood vaccina
