We agree with Jane Moir's report (South China Morning Post, November 5) that cervical cancer is largely preventable by appropriate screening, and unfortunately cervical cancer appears to be relatively more common in Hong Kong, compared with other countries which have population-based organised screening programmes.
However, contrary to the suggestion in your article, there has been little change in the overall proportion of deaths from cervical cancer in the SAR during the past 10 years.
Unlike many other forms of screening, a pap smear detects abnormalities before the actual onset of cancer so that, with appropriate management, over 90 per cent of women who are regularly screened are protected from the disease.
The mixed medical economy in Hong Kong means that cervical cancer screening is provided in an arbitrary fashion by both the private and public health sectors. Women may have pap smears in clinics provided by the Department of Health, the Hospital Authority, the Family Planning Association or in a range of private practices. However the impact of this mix of services on coverage of those at risk is low and the best estimates suggest that only about 30 per cent of eligible women in Hong Kong have regular pap smears.
In order to reduce the number of cases of cervical cancer, all women who have been sexually active should be encouraged to attend for regular screening. This can only be achieved if screening services are accessible, acceptable and affordable for all women.
There also need to be good quality-control measures in place to avoid abnormalities being missed, or women with abnormal smears being inadequately followed up. We agree with Professor Hextan Ngan Yuen-sheung that Hong Kong needs an organised system of screening which must be centrally planned, co-ordinated and continuously monitored and evaluated.
