A woman's health expert and advocate says the recent news of Labour MP Kiritapu Allan's cancer diagnosis highlights the importance of cervical screening.
Photo: GARO / Phanie
Allan shared the news on social media yesterday, and described her experience of being diagnosed with stage three cervical cancer.
She described her symptoms including stomach, back and leg pain and continuous bleeding.
Her social media post has prompted conversation and encouraged people to get a cervical smear test.
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The hashtag #Smearyourmea has resurfaced. It was first used by kapa haka star Talei Morrison who used her own experience with cervical cancer to encourage her fellow female kaihaka, or haka performers, around the country to be tested. Morrison passed away in 2018.
Clinical director of Primary Care Women's Health at the Auckland District health board, Orna McGinn, said news like Allan's reinforces the importance of regular screening.
"Almost all cervical cancers are in woman who've been under screened or un-screened."
"There is a proportion of women who worry about being screened or perhaps don't understand the importance of being screened and if you don't get screened, those are the women unfortunately that we see presenting with abnormalities further down the track."
According the Ministry of Health, each year there are around 250,000 abnormal smear test results in women.
Without cervical screening about one out of 90 women will develop cervical cancer and one out of 200 will die from it, but with cervical screening about one out of 570 will develop cervical cancer and one out of 1280 will die from it.
Regular three-yearly cervical smear tests are recommended for all people with a cervix aged 25 to 70 who have ever been sexually active.
But McGinn says the cost of a test in New Zealand can vary from free to around $70 depending on where you go.
"We do know that cost can be a barrier."
She says most DHB's run outreach services such as free clinics for people who cannot afford the cost.
"There is a mobile unit in Auckland that will travel around - a bit like the breast screening bus - to make sure women can access services."
At Family Planning, New Zealand residents under the age of 22 can get a cervical screen for free, for those with a community services card it is $5 and for those over 22 and without a community services card it is $40. Reduced costs will apply in some areas.
[h] Calls for HPV self-swabbing
Cervical cancer is caused by some strains of the human papillomavirus (HPV) which is a common virus passed on by sexual contact.
Kiri Allan's announcement has prompted renewed calls for the government to fund a self-swabbing cervical cancer programme allowing people the privacy and convenience of taking a simple HPV test at home. It was due to be rolled out in 2018 but the government put it on hold.
Professor Doctor Beverley Lawton, who did a pilot study of the proposed HPV self-screening [https://www.rnz.co.nz/national/programmes/checkpoint/audio/2018790464/health-leader-baffled-why-hpv-self-test-not-govt-funded told Checkpoint] that the current screening programme is not serving women and is failing a section of New Zealanders.
"I'm totally baffled," Dr Lawton said.
She said currently the screening programme is not working because it does not reach out to communities, and there might be stigma around sexual health for some people.
"Also it's cost, it's distance, if you're working… there's a number of reasons why, and that is contributing to the programme not being able to help all women in New Zealand."
Orna McGinn agrees with the call for a government implemented self-swabbing programme.
"This is something that has been implemented in several countries abroad and HPV self-testing has been shown to be very accessible and acceptable.
"I think probably as part of a woman's health strategy this would be an appropriate thing to be looking at implementing - yes."
HPV can also be vaccinated against. In 2008 a HPV immunisation programme began in New Zealand and according to the Ministry of Health website over 300,000 New Zealanders have been immunised against HPV since.
Orna McGinn said the vaccine is key in the fight against cervical cancer.
"We are already seeing worldwide that vaccination has dramatically reduced the rates of cervical cancer and the WHO feel that this is an eradicable disease, but it entirely depends on the rate of uptake of the vaccine."
She said currently the rate of uptake is around 67 percent and in some populations such as Māori women it's less than 50 percent.
"There is still a big equity gap."
Māori women in New Zealand are more than twice as likely as Pākehā women to be diagnosed with cervical cancer and are three times more likely to die from the disease.
McGinn said going forward there needs to be an over-arching woman's health strategy.
"Woman's health at the moment is very patchy, there's not really a joined-up approach to woman's health looking at all of the different issues that they might encounter over their life course.
"There are three active petitions and two petitions that have just closed presented to parliament looking at different aspects of woman's health such as improvement in outcomes for ovarian cancer, improvement in maternal healthcare post-birth and also introduction of HPV self-testing. But I think it shows really the level of need and the fact that perhaps woman feel that their needs are not being met currently."
McGinn said that Kiri Allan's message is "powerful".
"It's so terribly sad when anyone in the public eye develops a health issue but to turn it into a - you know - brave discussion about how you can help others with that is really very powerful."
Kiri Allan is taking immediate medical leave.
Kris Faafoi will be Acting Minister of Emergency Management, Dr Ayesha Verrall will be the Acting Minister of Conservation and Peeni Henare will be Acting Associate Minister for Arts Culture and Heritage.
With a community services card, a cervical smear at Family Planning is just $5.