Pandemic exacerbates women skipping life-saving screenings
NASSAU, BAHAMAS — Only 10 percent of women in The Bahamas received cervical screening tests prior to the pandemic and with the onset of the coronavirus disease, pap smears fell to an all-time low, according to one well-known obstetrician/gynecologist (OB-GYN).
Dr Shamanique Bodie-Williams works as a consultant physician in Grand Bahama’s public health system and operates private clinics in Freeport and on New Providence. She is also the author of “Progression: A female adolescent and parent’s guide to gynecological health and Being Breast Aware”.
“Cervical cancer is a very common yet highly preventable disease but still, women are dying from it,” she said.
“Bahamian women have historically been reluctant to undergo their annual pap smear, a screening test used to find changes in the cells of the cervix that could lead to cancer.
“Not surprisingly, COVID-19 has made matters worse. Our national awareness of cervical cancer, a gynecologic malignancy which does not discriminate, has dropped to an all-time low.”
January is Cervical Cancer Awareness Month, an observance that provides a platform for the fourth most common cancer for women globally. It trails breast, colorectum and lung cancer.
“Nobody likes getting pap smears. It’s intimate, invasive and uncomfortable. But it can also be lifesaving,” Bodie-Williams said.
According to Dr Raleigh Butler, the nation’s first gynecologic oncologist, in the late 1990s, cancer in the female reproductive system totaled around 60 cases annually in the public health system.
There were around 25 cases of cervical cancer, 15 to 20 endometrial, 10 ovarian and two each of vaginal, vulva and gestational trophoblastic disease, said Butler, whose practice spans 35 years.
The numbers dipped in 2007, which he attributed to an increase in colposcopy, but began increasing in 2013, primarily due to a decline in the number of colposcopies triggered by a lack of resources and manpower.
With the onset of the pandemic and patients postponing care, Butler believes the number of female reproductive cancer cases could be as high as 80 to 100 patients.
When it comes to cervical cancer, historically, rates in The Bahamas have been higher than developed countries.
In 2017, the latest figures available, Princess Margaret Hospital recorded six cervical cancer deaths out of 12 cervical cancer patients receiving treatment that year at the facility.
In the case of Bodie-Williams’ practice, anywhere from 10 to 15 percent of the pap smears she carries out are abnormal. At that point, patients receive different recommendations based upon the abnormality.
Almost all cervical cancers are caused by HPV, a common virus. Since the 1990s, the strategy for battling HPV has been prevention via vaccination of women up to 45 years old.
Vaccines prevent over 99 percent of some HPV types in women who have not yet been exposed.
In The Bahamas, essential childhood vaccines like HPV have been delayed since parents have been reluctant to make alternate vaccination appointments or keep existing ones due to the pandemic.
“Globally, fewer vaccines have been given during the pandemic. It’s going to be vital for parents to catch up on their child’s routine immunization/vaccination schedule as soon as possible to avoid increased risks for outbreaks of vaccine-preventable diseases,” said Bodie-Williams.
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