Whanganui experts say reluctance to undergo cervical screening still an issue

Jude MacDonald says New Zealand is not proactive when it comes to getting screens. Photo / Supplied

Many women in the local community are still not making cervical screening a priority, Whanganui Regional Health Network chief executive Jude MacDonald says.

That's despite the screening process being easily accessible and taking only five minutes.

Her comments follow Minister of Conservation and Emergency Management Kiri Allan's cancer diagnosis which has put the spotlight on the importance of cervical screening.

As a population, New Zealand wasn't proactive in getting screens, MacDonald said.

"Personally, I was devastated to hear about her [Allen's] diagnosis, and it just goes to show that it doesn't matter how educated you are, we all carry a number of personal reasons as to why we don't put ourselves forward early for something which is a five-minute screening process," MacDonald said.

"In my opinion, lack of access to screening isn't the main issue facing women.

"It's around trying to get women to understand that if you're monitored early and screened early, you absolutely have very good outcomes."

Whanganui GP Allan Mangan said a high-profile case such as Allen's was bound to prompt people in the community to pay greater attention to their own wellbeing.

"It brings the reality of it to the general public," Mangan said.

"Everyone thinks they're immune from these things, but they're not.

"It's a salutary reminder that screening programmes are there for a reason, and they're going a long way towards the prevention of serious diseases such as cervical cancer."

A number of cultural issues played a part in people choosing not to have a cervical screen, Mangan said.

"I totally understand that, but even in circumstances where those things are overcome and put aside, you can still get a reluctance from people to take this programme up.

"Obviously, a cervical screen still involves, at this stage, some degree of embarrassment for a lot of people."

Whanganui GP Alan Mangan. Photo / Supplied

Mangan said a national rollout of cervical self-testing could potentially alleviate some of those concerns but, even then, there would still be those who chose not to get screened.

"Even with the bowel screening programme, which you can achieve in the privacy of your own home, we still don't have people taking up the opportunity.

"It might be the fear of the unknown, or discovering something you don't want to know about and, again, that's completely understandable."

Keeping the cervical screening programme "front of mind" was important, MacDonald said, because diagnoses like Allan's weren't uncommon.

"There are a number of other women that we don't know about that have received a similar diagnosis and are going through a similar treatment.

"It could have all have been preventable if they'd had smears regularly, or had access to smears.

"We're not guaranteeing that everyone across New Zealand has good access, so, as providers and leaders in health, we need to be monitoring that very closely as well."

Dr Bill Douglas, a GP at Jabulani Medical Centre, said campaigns such as Smear Your Mea had made the screening process more normal and acceptable for the public, but general practice still had a part to play in engaging people with the screening programme.

"There are a lot of things you can do in the practice, like asking about other members of the family," Douglas said.

"When Junior comes in for his immunisations you can say 'Mum is due for her smear'."

Building relationships and trust with patients was "the essence of general practice", Douglas said, and those bonds could encourage people to get screened.

"Try not to do everything on the cheap and over the phone, it's got to be general, and the doctor has to practise."

Kiritapu Allan with her daughter, Hiwaiterangi, after receiving a diagnosis of stage 3 cervical cancer. Photo / Supplied

MacDonald said women with a lot of commitments were not putting themselves first a lot of the time, so things like screening reminders could easily be forgotten or cast aside.

"I can honestly put my hand up and say that I've had regular updates saying I'm overdue and I've popped it in the bin and said, 'Yeah, I'll get on to that'.

"Someone's tapped me on the shoulder and said, 'This isn't good enough'.

"We're all guilty of it, all of us. Some of those bowel screening kits are sitting around in people's houses waiting for the opportune moment.

"We feel fine, we don't have symptoms, so therefore we're okay. It's an unknown killer that we don't know is there until it's too late."

Mangan said he was sure Allan would be happy that any publicity around her own diagnosis would potentially prevent some other cases of cervical cancer in the future.

"The programme is available for people, and we're going as far as we can.

"When I first started in general practice I used to do all the cervical smears, as a male doctor.

"That was always a cause for concern for me personally, and also probably for the women I was doing cervical screening on.

"Now we have highly trained nurse smear takers, so hopefully that has relieved that side of the issue.

"It's like a lot of things in health, you can take a horse to water but you can't make them drink.

"Human beings have the right to make their own decisions about these things, just like they do with the Covid-19 vaccine."

For more information, go to www.timetoscreen.nz/cervical-screening