Cervical screening – Ruth’s story

SCREENING ESSENTIAL FOR EVERYONE WITH A CERVIX

Abnormal cells detected and treated early after celebrity death raised awareness of benefits of cervical cancer screening for Dublin woman Ruth

MY STORY

Ruth O’Mahony

Like most people of her generation, 46-year-old Ruth O’Mahony became aware of cervical cancer when English personality Jade Goody was diagnosed with the disease. “I was a fan of Big Brother and I remember when she died in 2009. It resonated. At this stage I had two children – the youngest was nine. That story frightened me a lot, and I had it in mind I should have gone for screening at some point,” says Ruth.

In the summer of 2009, with the National Cervical Cancer Screening programme CervicalCheck still in its infancy, Ruth had her first screening test.

“The nurse phoned me to say they weren’t happy with the results of the test. I had precancerous cells. She was reassuring on the phone but said I did need to go to the colposcopy clinic in Cork. This was arranged for me and a week or two later I had an appointment in St Finbarr’s. I met the consultant and he was very good at explaining what was going on,” said Ruth About six in every 10 people who go on to colposcopy after cervical screening will have abnormal cells detected in their cervix. These abnormal cells are called ‘cervical intra-epithelial neoplasia’ or CIN. CIN is not cancer, but there is a risk it could turn into cancer if left untreated. Ruth’s consultant told her it was likely she had CIN3 – which meant there was a high chance the cells

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would become cancerous, and treatment to remove them was recommended.

“My consultant said it had to be dealt with as quickly as possible. He explained that if I had let it go for a number of years, it was highly likely the abnormal cells would turn into cancer. I felt I was very, very lucky. If I had continued to do nothing, and not go for screening, I would have been in trouble. I would have been dealing with cervical cancer and worrying about my children… I was very relieved I had gone for screening,” she said.

The biopsy confirmed that Ruth had CIN3, and she had a LLETZ procedure to remove the cells. “At my follow-up six month screen I wasn’t given the all-clear. But by September 2010 my result was clear and I have been going for my follow-up screens since.”

Ruth is a member of LINC – the lesbian and bisexual women advocacy group based in Cork. The group has been involved in the creation of a new report from the National Screening Service entitled LGBT+ Cervical Screening Study.

“There seems to be quite a number of lesbian and bisexual women who think they don’t need to go for screening because they are not having sex with men."

International evidence shows that lesbian and bisexual women and gender minorities with a cervix have significantly lower rates of uptake of HPV and cervical screening. Ruth tells her experience of cervical screening to friends and people who use LINC’s services, so they know all about their own options for cervical screening. She emphasises the relevance of cervical screening to all women and people with a cervix.

“There seems to be quite a number of lesbian and bisexual women who think they don’t need to go for screening because they are not having sex with men. And just like women in the community as a whole, many also don’t like the invasiveness of the procedure,” said Ruth. “I do describe it as uncomfortable – but that it’s only for a few seconds. I have found it difficult to convince even close friends – I have one friend who has never been for screening – but I do tell my story to people… what I could have been dealing with if I hadn’t gone for screening.”

LGBT+ CERVICAL SCREENING STUDY EXAMINES KNOWLEDGE OF AND PARTICIPATION IN CERVICAL SCREENING IN IRELAND

The National Screening Service, in September, launched its report entitled LGBT+ Cervical Screening Study, in partnership with LINC - a nongovernmental organisation working with lesbian and bisexual women and their families, and CervicalCheck – the national cervical screening programme. The study examined the knowledge of, attitudes towards, participation in, and experiences of cervical screening in Ireland. It was open to lesbian and bisexual women, trans men, non-binary, and intersex people. Approximately 450 people who identify as LGBT+ took part in this study, between October 2020 and March 2021. It was found that while the majority have said they had positive experiences of cervical screening, only about two thirds (or 66%) of people said they attended cervical screening regularly. This compares to 80% attendance by the general population. Dr Sarah Fitzgibbon, Primary Care Clinical Advisor for CervicalCheck said, “One finding that stands out is the inaccurate information circulating in the LGBT+ community that cervical screening may not be necessary for them. CervicalCheck invites every person with a cervix in Ireland aged 25-65 years for free cervical screening, every three or five years depending on age. The aim of the programme is to detect abnormalities in the cervix that, if left untreated, could develop into cancer. Therefore it’s important that everyone who is invited attends.” Anyone with a cervix is at risk from cervical cancer and should avail of regular screening (HSE.ie, 2020). International evidence, spanning more than two decades and from a broad range of countries, demonstrates that lesbian and bisexual (LB) women and gender minorities with a cervix (GMC) have significantly lower rates of uptake of HPV and cervical screening. This study sets out to examine the situation in Ireland against this backdrop. Dr Nóirín Russell, Clinical Director, for CervicalCheck, said, “Following the publication of this report, CervicalCheck is committed to a number of actions, such as: increased training and supports for sample takers; inclusion of and communication with the LGBT+ community in cervical screening; more targeted messaging and campaigns for the LGBT+ community, working in partnership with the people we care for in screening; and further research.” We look forward to implementing these recommendations alongside our partners in LINC and the wider LGBT+ community.