Get a Pap smear; Cervical cancer is 100% preventable

The Todu Guam Foundation is leading the effort to educate people with cervixes about cervical cancer, and providing the diagnostic tools to underserved women that will make them cervical cancer-free. Over the past four months the foundation has provided about 500 cervical cancer screening tests – Pap smears – and it will continue to provide these to women at no charge.

Cervical cancer is a leading cause of death on Guam and throughout Micronesia, and effectively is 100 percent preventable. The first step is a Pap smear. If an abnormality is found, a gynecologist will conduct a simple, non-surgical procedure to remove cancer-causing substances from your cervix. And that’s it.

“If I do a Pap test and you follow my directions, cervical cancer is 100 percent preventable with early detection,” Dr. Thomas Shieh, an obstetrician-gynecologist, said. “A pelvic exam takes less than two minutes.”

A Johns Hopkins Bloomberg School of Public Health article, Cervical Cancer is Preventable, by Melissa Hartman, published January 24, 2023, agrees with Dr. Shieh:

“Cervical cancer is a 100% preventable cancer. We have two great tools—HPV vaccination and cervical cancer screening—which are both important in preventing cervical cancers. HPV vaccination is recommended for everyone age 26 or younger since it prevents new HPV infections but does not help clear HPV infections you already have. For older individuals who did not get the HPV vaccine, screening can help to detect cervical pre-cancers when they are small and treatable and prevent cancer from occuring.”

HPV stands for human papillomavirus, and it causes most cervical cancers, according to the U.S. Centers for Disease Control and Prevention. HPV is sexually transmitted; boys and men also are carriers.

Todu Guam has administered 253 HPV vaccines, almost guaranteeing that 253 young women on Guam will not develop cervical cancer. The foundation will continue to offer these vaccines to women 26 years old or younger. For everyone else, prevention of cervical cancer can still happen, starting with the Pap smear.

In a 21-year period, the Guam Department of Public Health and Social Services administered 5,972 Pap smears, according to an article last year by the Pacific Daily News. That is an annual average of 284. In a less-than-four month period, the Todu Guam Foundation provided nearly double that annual average, making the foundation and its clinic the leading agent for cervical cancer prevention for underserved women in the region.

That regional distinction is important, as data for Guam showing vast disparities among ethnic groups of cervical cancer incidence, compared against data in home countries throughout Micronesia suggest thousands more women in the region need to get Pap smears as a start to preventing any cervical cancer deaths.

“If we can 100 percent prevent cervical cancer, then even one death is too many,” foundation president Lena Calvo-Rodriguez said.

According to the paper “Ethnic Disparities in Cancer Incidence among Residents of Guam” published in 2015 and found on the National Institutes of Health website:

“Micronesians had the highest age-adjusted cervical cancer incidence rates on Guam, at 27.4 almost 3 times the U.S. rate of 9.6. Chamorros (16.2) and Caucasians (10.5) on Guam also had higher rates than the U.S. average while Asians (8.5) and Filipinas (8.4) had slightly lower rates during the period studied.”

Chuuk’s cancer incidence rate, according to data published by the Pacific Regional Central Cancer Registry for 2007-2018 data, does not include cervical cancer in its top three for incidence and 5-year survival rate. Yet on Guam, “Micronesian” women, of whom Chuukese women make up the majority, have the highest incidence of cervical cancer, by far.

“We believe the reason there’s such a disparity is because women in Chuuk are not being offered Pap smears to diagnose any problems,” Ms. Rodriguez said. “We also think the incidence on Guam is even higher because of the number of women who are not getting Pap smears and then starting the process of treatment to prevent cervical cancer.”

The foundation has translated its education materials on cervical cancer into several languages, including Chuukese.

To get their free HPV vaccines, you must be 9 to 26 years old. The free pap smears are for 21 years old and up. This program is funded by a grant from the Guam Cancer Trust Fund, which soon is expiring unless the trust fund regrants the foundation.

“We’re going to find a way to make this work,” Ms. Rodriguez said of the foundation’s HPV vaccine and Pap smear test program in the event the trust fund does not regrant the foundation.

Call the number on the flier, or visit the link on it to schedule your appointment for either the vaccine or the Pap smear.

You may also call Dr. Shieh’s Clinic at (671) 648-BABY (2229).

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