When Victoria marketing manager Sue Dakers last visited her sister in England in 2010, their chats turned personal and Dakers admitted she hadn't been taking care of her health. Specifically, for five years, she had avoided having pelvic examinations that could detect the changes that lead to cervical cancer.
Her "astounded" sister made Dakers promise to have a cervical screening test as soon as she got back to B.C. Which was profoundly fortunate.
"It turned out that there was something that needed to be addressed urgently," Dakers, 50, recalls. "It was pre-cancerous but it was very close to cervical cancer."
It was an ironic turn of events, because Dakers had always found "the most terrifying" part of a Pap appointment was not discomfort or embarrassment but the spectre of a call back from a medical office about an abnormality. "And that's the thing - the longer you leave it, the more terrified you get."
She was so grateful for a sister who encouraged her to face her fears, but worried about other women with no one to turn to for support. The result: Screening Sisters, a volunteer peer support group. It launches this week following more than a year of liaison with the Canadian Cancer Society, B.C. Cancer Agency and Island Sexual Health.
With the help of about eight members of Dakers's social circle, a woman will be assigned a companion to support her at appointments for a cervical screening test, getting the results or for phone conversations between appointments - which can be several stressful weeks or even longer, she said.
"It's a phenomenal program," says Jennifer Gibson, the co-ordinator of educational services for Island Sexual Health. "Many women who develop cervical cancer haven't had regular cervical screening - not all, but many."
In fact, 14 per cent of Canadian women have never been screened and one in three haven't been screened in the previous three years, even though Pap tests depend on detecting changes in cervical cells over time, the Public Health Agency of Canada warned in 2010.
For young women, dread of the test has not gone the way of some other old wives tales. Recently, Gibson spoke to a group of teens heading out of town for university and the uniform reaction to having a Pap test was: "No, ew, and I don't want it," she says.
But when she brought out a plastic pelvis to show them what it entails, "they were all keen to look at what the inside of their bodies look like."
"Breaking through that fear and having support - that's where something like Screening Sisters comes in."
When people dread something, they tend to avoid it, sometimes with tragic results. In 2009, there were 171 new cases of invasive cervical cancer in B.C. and 33 deaths, according to the B.C. Cancer Agency.
Given the current level of screening, it's estimated that two cases are prevented for every case diagnosed, the B.C. Cancer Agency reports.
Even women with a friend or relative who would happily accompany them may feel more comfortable with a supportive stranger, Gibson said, since it can be hard to say: "I need someone to come with me."
To make the process less intimidating, Gibson uses terminology such as screening rather than Pap smear and foot rests rather than stirrups. She also encourages women to give themselves enough time to relax for the appointment that for some underscores "a power imbalance" position with the practitioner.
Guidelines for the College of Physicians and Surgeons of B.C. state that if a patient requests a support person in the room for intimate exams, the request must be honoured. So-called chaperones in the room are not mandatory, but could add to a patient's feeling of comfort and security, the guidelines state.
Women do not have to be having intercourse to require a Pap test, she said. Even skin-to-skin touching in the genital area can spread Human Papillo-mavirus and two or three strains of that lead to almost all cervical cancers. Even HPV vaccines cannot prevent cancers that Pap screening can detect, the B.C. Cancer Agency notes.
To get women to those appointments, Dakers has paid the cost of printing Screening Sisters brochures herself and would distribute them more widely if she could access funding.
"If this is successful, I'd like to roll it out everywhere, basically. Not just in Victoria. It's so important to me because I know what it's like.
"Our gut [feeling] is there are a lot of women out there who are scared." For more information, call 250661-4413 or 250-478-2477. [email protected]
SCREENING: RECOMMENDED ONCE EVERY TWO YEARS
Cervical Cancer Facts and Figures
The cervix (Latin for neck) is the point where the uterus narrows to meet the upper end of the vaginal canal.
B.C. began the world's first Pap test screening program in 1949, which has led to a 70 per cent decrease in cervical cancer since then.
The B.C. Cancer Agency recommends beginning screening at age 21 or about three years after sexual activity begins - which ever comes first - and for three consecutive years. Previously, the guideline was to start screening at the time of first sexual activity. After three normal screens, tests are now recommended every two years until age 69, provided tests results have always been normal.
Most cases of cervical cancer in B.C. are diagnosed in women ages 40 to 59.
Statistics from 2007 through 2009 indicate B.C. women ages 30-39 are most likely to have had at least one test in those three years, with the overall percentage at 78.5. For women ages 20-29 on north Vancouver Island, 87 per cent had had at least one test, compared to 69.7 per cent on the South Island, and a B.C low of 49.3 per cent in Richmond.
The five-year survival rate for cervical cancer survivors following initial eradication is 77 per cent. Last year, Island Sexual Health clinics performed more than 4,000 cervical screenings, from teens to women in their 80s, including trans people with a cervix.
Women who don't want to go to their family doctor for Pap tests are also welcome.
