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‘My result was not good. I had PAP-4, a precursor of cervical cancer’

Go send that invitation when a woman turns twenty, instead of thirty. My result was not good. Not even at all. I had PAP-4, a fairly serious precancerous stage of cervical cancer.

Population screening and smears. It’s one of those things that no woman wants or wants and for some it’s not on the priority list at all. Still, I wanted to dedicate a column to this topic, as not-nice as it may be. After all, sooner or later every woman has to deal with it.

In the Netherlands, when we are thirty, we are invited for the cervical cancer population screening. You will receive the letter around your birthday. A super nice gift. I will not go into all the medical advantages or disadvantages of participating in such a study, but I can share my own experience.

When I was thirty I lived on Curaçao. As far as I know they don’t do population screenings there. I could be ultimately wrong, but I never received a letter that I was summoned. I don’t think I had any idea at the time, so I didn’t go to the doctor myself. Not that that was a big deal, because when I lived in the Netherlands again – three years later – I did go and I had a PAP-1 score. Fine, nothing to worry about. I have no idea whether the HPV virus was already found in me at that time, at least I have not heard anything about it (or I have forgotten it).

Anyway, a woman close to me had a bad Pap smear result two years later. It was the first time I heard someone who didn’t have a good result. Maybe it was the first time I heard anyone talk about it at all. PAP 3B, in other words: not good. Referral to the gynecologist and treatment followed. Despite the fact that it wasn’t all that exciting and the bad cells had been cleared up after the treatment, it did make me think. Maybe I should go again. I don’t know why I had that feeling, after all I had been there two years before and then nothing was wrong. The doctor thought so too. It was a very slow-growing thing. Actually it was not necessary and besides: I had no complaints.

“Do it anyway,” I said.

Being stubborn is sometimes good. Go against advice. Maybe it was a life saver this time. My result was not good. Not even at all. I had PAP 4, a fairly severe precancerous stage of cervical cancer.

‘How?’ I called on the phone. ‘I was there two years ago!’

The doctor did not have an answer, but I did get a referral. Fortunately, I was able to see the gynecologist very quickly, who remained calm and reassured me. He didn’t think it was all that terrible, he had seen worse. Thank God it was still a preliminary stage and everything was neatly ‘cleaned’. I was off again. I decided at that moment that I was going to talk about it and warn others. It is not something to be ashamed of and openness is always better, especially if you can help someone else with it.

So I started the conversation. Tossed it on the table in the team room at work, discussed it with girlfriends and nieces. Guess what? There were so many women who also had a bad PAP result! In my immediate environment maybe three quarters of the women I spoke to about it. 90% of the women get a good result, says the RIVM folder. Only 3% have to go to the gynaecologist. And the 10% that do get a bad result happen to all be women I know? How can this figure be so low, but are the stories from my immediate environment so different? The reason for writing this column is an app from one of my nieces in our Nieces Rules appgroup. She also received a less pleasant result from the doctor. Another one in the already long line of ladies who preceded her. How?

Without wanting to scare anyone with this or to be a pedantic, please go to the population screening and have that smear taken. No, it’s not fun, it’s certainly not my hobby, but if you look at all the misery you can prevent with it … A bad result gives the opportunity to be treated and believe me, you really want that rather than another getting worse results, with that one k-word no one ever wants to hear in their life. I think nowadays you even have the option to order a self-sampling test. Do it! For real. There are in fact no reasons not to participate, because it is about your health. I even think that they should bring the population screening ten years forward, just send that invitation when a woman turns twenty, instead of thirty. But yes, that will be too expensive. The fact that we can go is of course already a privilege.

As soon as I’ve given birth and it’s possible again, I’ll go to the doctor. Just to check. The two times after my treatment at the gynecologist – four years ago – I had a proper PAP 1. I was allowed to re-enter the population screening, without extra checks. Still, it remains exciting for me, because I have already gone from PAP 1 to PAP 4 in a relatively short time. And again, it’s not fun. The Pap smear or the result may make you tense, but it’s always better than burying your head in the sand and then hearing that you have cancer when it could have been prevented.

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