Every May 28 the International Day of Action for Women’s Health and, in this way, raise awareness of the importance of their sexual and reproductive health. And it makes more sense in these times when Covid-19 It has been a focus of personal, social and health efforts for more than a year. Consequently, the investigation of serious diseases that affect women has been left in a less advantageous position: breast and cervical cancer, whose check through the Pap smear (PAP) and referral to mammography perform midwives and midwives, who are in charge of gynecological controls in Cesfam.
Impact on women
“Unfortunately, the human resource of the public service, midwife and midwife, has been redistributed towards traceability or vaccination functions of Covid-19, for example, so there has been a decrease in the opportunities for consultation or controls that were scheduled annually”, warns Carolina Bascur, midwife and director of Department of Obstetrics and Childcare of the Faculty of Medicine of the University of Concepción (UdeC). The fear of going to care centers and be exposed to Covid-19, on the premises or on the way, which also manifests itself in the private system with downward gynecological consultations.
Therefore, although the controls and taking exams are being carried out, the experience of the professionals indicates that it is not with the frequency or massiveness that existed before the Covid-19. Given this, Carolina Bascur will participate in an investigation to quantify the decrease in taking PAP exams and mammograms in 2020 versus 2019 and then analyze the effect on women’s health. “Because it will have an impact”, he assures. Is that if the controls are not carried out with the established regularity, there could be delay in the investigation cancer precursor lesions or pathology in early stages: key to initiating timely treatment and better prognoses.
Periodicity
The PAP detects precursor cancer lesions in the cervix, which Carolina Bascur highlights that “In 99% of cases they are caused by the human papillomavirus (HPV), which is transmitted only through sexual contact”. Are therethe most common sexually transmitted infection (STI) and the Ministry of Health (Minsal) estimates that It is carried by 20% to 30% of women under 30 years of age and it also causes other cancers and conditions. After 6 months of the woman’s first penetrative sexual intercourse, PAP should be started. “If the result is negative, there is no injury or suspicion, it is repeated every 3 years in the public system”According to Minsal recommendations, at the private level it is usually asked once a year if the woman is checked annually. “If there are risk factors, for example, an altered PAP and treatment for cervical pathology, the PAP is annual”, dice.
In the mammography, used for early detection of breast cancer, leading cause of death in women in Chile, “You have to start at 35 years of age and do it once a year when there are family risk factors: mother, grandmother, aunt or sister with breast cancer. In women with no antecedents, it is suggested that from the age of 50, an annual mammogram should be started ”, Explain.
“This periodicity has confirmed that the disease is investigated in time and that whoever has an injury receives the treatment it requires. For example, if one is found in the cervix that avoids reaching a cancer “, he maintains. There the alert for the lower frequency in controls, because there will be women who, if they have allowed a year or more to pass without going as established, diminished the ability to prevent something complex and will arrive later, requiring more complicated approaches and with more commitment to quality of life, Bascur regrets.
It will not be the reality of all and the highest probability is for those who have risk factor’s such as a family history of breast cancer or having had an HPV lesion. Immune health influences, therefore “The virus can be kept attenuated, but with the current stress they can lower defenses and take advantage of the opportunity to replicate and alter cells”, he assures. Warn that having multiple sexual partners and not using a condom increases chances of STIs in general, such as HPV and HIV.
Care and prevention
It is clear what is required to take care of yourself. First, the responsibility in the intimate sphere, where in addition to maintaining a single sexual partner to prevent STIs, a male or female condom must be used, he highlights.
But, the most important thing is that “The safest way to prevent and arrive in time for these cancers is PAP and mammography”, asserts Carolina Bascur. The call is not to fear Covid-19, but the possibility of not detecting early and that women go to their controls and do not let more pass if they are late, finding out about the hours of attention that are in the Cesfam or go to a doctor or doctor of the private system. Along with self-care measures, about how to properly use the mask, for example, in health facilities there are protocols for gynecological controls and take exams safely.
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