Filenews 8 April 2022 - by Marilena Panagi
The age group of women who will participate in the population screening program for breast cancer is growing, while the Ministry of Health and the HIO admit that there are gaps in the proper treatment of women through the services offered by the General Health System, resulting in some cases a delay in diagnosis. At the same time, parliamentarians, scientists and patient associations demand the extension of the age group of children (girls and boys) vaccinated for HPV, which is responsible for cervical cancer.
As far as the mammographic screening program is concerned, the Deputy Director of Medical Services, Olga Kalakouta, told the Health Committee of the Parliament yesterday that it is "autonomous", will now have its own staff (whereas previously it was based on the staff of the CySEC) and it is planned to extend its opening hours. At the same time, four new digital mammographers are purchased, while the extensive areas in which mammograms have been performed for years are also upgraded. In this way, Ms. Kalakouta said, it will be possible to extend the age group of women undergoing mammography.
Specifically, while to date the program concerns women from 50 to 69 years old, a decision has been taken but has not yet been implemented to reduce the age limit to 45 years, and at the same time in response to statements by doctors and representatives of associations, he mentioned that since the program becomes autonomous, it is possible to extend the age group upwards and specifically to 74 years, as it has now begun to happen in several European countries. However, he referred to the National Commission for Cancer, which recently began its operation and from which the Ministry of Health expects recommendations in this regard. For every age, Ms. Kalakuta said, an estimated 5,000 more women participate.
The Parliamentary Health Committee was studying a proposal that was submitted by all its members of parliament and concerned the age group of women undergoing mammography, free of charge through the population control program of the Ministry of Health, as well as the annual screening of women with Pap smears within the GHS.
Regarding the frequency with which women undergo mammography, HIO, scientists and patient associations argued that this differs from country to country. In some countries, the frequency changes depending on the age group and concerns examination every two years, three years or even five years. In Cyprus, the examination is performed every two years for prevention purposes, while the GHS covers all diagnostic mammograms. That is, in cases when the doctor or woman detects something in the chest, then automatically the woman is referred for examination. The same applies when the woman meets certain criteria, which have been adopted by the HIO.
On the part of the Patients' Associations, the need to improve the quality of the services received by women was further underlined than the need to reduce the age limit of the women examined, while both the representatives of the patients and the representatives of the National Cancer Commission pointed out the gap that exists due to the non-connection of the population control program of the Ministry of Health with the ghsy's software system. As characteristically mentioned by a representative of the CySEC at this time, women who undergo mammography through the Program when they have findings, turn to their doctors without their result being registered in the GHS system. This, as they said, is something that must be sorted out without further delay.
It was also pointed out the need to give personal doctors the opportunity to directly refer women who identify something suspicious in their breasts for mammography, since now personal doctors do not have this possibility, they refer women only to ultrasound and this results in many cases being delayed in the end to be diagnosed with what, what that entails.
On this issue, the HIO spokeswoman said that there does not appear to be a problem to meet the relevant request however, she said, there must be the necessary guidelines and protocols to be completed by the doctors.
The representative of the National Commission for Cancer, in response to a question, said that cancer rates in Cyprus do not seem to differ from the rates recorded in the rest of the EU. Specifically, he said, from 1998 to 2018, 11,000 cases were recorded involving people under the age of 44, a number that corresponds to 16% of the total cases recorded by the Cancer Archive. He also said that the Commission is studying all the data and will soon proceed with recommendations to the health ministry.
From the point of view of the Members, it was also raised whether it would be possible, in the criteria used by the HIO to perform mammography, to include other indications such as the hormone therapy that women receive during an IVF attempt or for other reasons. It was even mentioned that at the moment women pay privately for these mammograms, which cost around €120.
It is necessary to extend the age limit for Pap smears
With regard to the proposal of the Members of Parliament for an annual Pap test for women through the GHS, the members of the scientific community who participated in the meeting stressed that we should place more emphasis on the vaccination of children for HPV, since according to international studies, with the increase in the vaccination rate, mortality due to cervical cancer is also decreasing. As it was characteristically mentioned, based on a study by the World Health Organization, a girl who was vaccinated, if she underwent a Pap test only twice in the rest of her life, will have a 33% less chance of cervical cancer and as it was pointed out, if we reach 80% vaccination coverage then the frequency of the test could be three or five years, from two that are today. It is reported that in Cyprus, girls and boys aged 11-12 are currently being vaccinated. Regarding the frequency of the Pap test in women, the participants of the meeting did not take a clear position on whether it should be carried out on an annual basis and not every two years and be covered by the GHS. However, it was stressed that this test should not end at 69 years, since the life expectancy of women in Cyprus exceeds 80 years and women cannot be left without a test for more than 10 years. Finally, the fact that there is no population control programme for cervical cancer was highlighted.
