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Combating the decreased attendance of women at breast and cervical cancer screening tests

Breast and cervical cancers are considered the most common cancers amongst women, and the American Cancer Society estimates the incidence of breast and cervical cancer for 2018 to be 266,120 and 13,240, respectively.  Unfortunately, fatality due to both is high, with the poorest prognosis occurring when the cancer has metastasized. If detected early enough, mortality rates drop significantly. And yet, doctors still struggle to convince women to undergo screening tests for breast and cervical cancers.

There are many risk factors for breast cancer, including a woman’s history of reproduction and contraception, alcohol intake, and family history of the disease. Screening tests include a mammogram (X-ray of the breast), which is largely considered the best way to detect early breast cancer. Breast MRIs are used along with mammograms to screen women who are at high risk for getting breast cancer. The American Cancer Society recommends that women should have the opportunity to begin annual screening between the ages of 40 and 44.  Cervical cancer, on the other hand, is caused by a virus transmitted via sexual contact, called human papillomavirus (HPV). Getting screened regularly increases the likelihood of diagnosing the cancer before it advances in stage, which can drastically reduce life expectancy— according to the American Cancer Society, the 5-year relative survival (2007-2013) for localized cervical cancer is 92%, compared to only 17% for distant.  The screening test is called a Pap smear, where cells are scraped from the cervix and examined under a microscope. 

Despite the advantages of getting these screening tests done, many women are very hesitant to do so. According to a study at Western Sydney University, an overarching reason for this is that these tests require partial nudity, which makes a number of women highly uncomfortable. To address this issue, a hospital in Thailand’s Kamphaeng Phet province, inspired by “The Mask Singer” television talent show, came up with a creative solution called “The Mask Pap Smear Campaign.” The hospital staff prepared masks for women, which they could wear during their breast or cervical cancer screening. In some instances, the medical staff also wore masks to make the women feel more comfortable when registering for the tests. The results of this campaign were very impressive, with up to 50 female mask-wearers turning up for the free screening tests compared to fewer than 20 women from before the campaign.

The Procter and Gamble Corporation in Taiwan adopted another creative strategy. It targeted the developing trend of Taiwanese women having afternoon tea by coming up with the slogan, “Save a life in six minutes.” It claimed that getting a screening test could be as quick and easy as drinking afternoon tea. The face of this campaign, supermodel Lin Chih-ling, said that the afternoon tea concept was developed in the hopes that each woman would cherish her health. This turned out to be very effective, as awareness of the screening tests rose significantly.

What these campaigns have in common is that they took the women and their cultural contexts into consideration. The Mask Pap Smear campaign focused on the unease of women at the idea of partial nudity. The afternoon tea campaign related the screening tests to something commonplace – afternoon tea – so women would be more comfortable with the former. Scaring women with statistics and mortality rates is an ineffective way to promote health screening tests. In order to combat these cancers, providers should consider the needs and concerns of women.212

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