Preventing cervical cancer

In an interview (April 14), the new president of the National Council of Women, Doreen Micallef, lists important problem areas she hopes to tackle, such as the dearth of women in non-governmental organisations, families having become non-environmentally conducive to child-rearing (costs and dual work households), unbalanced family/household tasks between men and women, other aspects of gender equality, and the problem of domestic violence.

On women's health, Ms Micallef quite rightly suggests sustaining educational and preventive measures against sexually transmitted diseases which may progress to infertility and cervical cancer. Her council intends urging the government to offer free vaccination (Lm180 each) against the most common (but not all) viruses that cause cervical cancer.

On the face of it this seems a very worthwhile and uncontroversial request. However, an effective means of preventing cervical cancer already exists (regular cervical smear test), and the government has been providing it free since the late 1970s (although we have organised national cervical cancer screening programmes).

The relatively few cases (five to 10 annually) of cervical cancer we get in the Maltese islands are almost invariably those who haven't had regular smear tests. The vaccine being proposed is thought to prevent up to 70 per cent of cervical cancers, so around a third may not be preventable by this first available vaccine, and regular smear tests would therefore still be required by the sexually active even if they've had the vaccine.

This is not to say the vaccine is not a major medical breakthrough but, in its present form, it is not expected to provide a water-tight solution - and it has a significant cost. The Health Ministry has other important competing revenue priorities to consider.

The interview, for example, doesn't touch on a much larger (around 200 new cases annually) women's health problem, namely breast cancer - the commonest cause of death among women aged 40 to 50.

Not only is there no government national breast cancer screening programme, there is neither free access to the latest very expensive breast cancer drugs which can make a significant difference to survival.

The UK national screening programmes for cervical and breast cancer were instigated by women lobbying politicians - Ms Micallef and her council have a long way to go to bring us up-to-date.