SMEAR CAMPAIGN

It's more than two years since I first wrote about the shameful fact that I have never had a smear test

It's more than two years since I first wrote about the shameful fact that I have never had a smear test. (I put "smear test" in the first line deliberately, by the way. That's so nobody can e-mail me to complain that I ruined breakfast.) I ended the article with an upbeat statement of intent. "A few minutes - and apparently that's all it is - of embarrassment is surely a tiny price to pay for such monumental peace of mind," I mused. "My friend and I are going to make an appointment together. I feel more grown-up already."

Hmm. More grown-up, eh? It's probably time for an update. The truth is, the friend hasn't been next or near to a clinic since then, and, until last week, neither had I. It seems that despite being mature, thirtysomething women, we couldn't get over our adolescent mortification at the thought of being poked and prodded. It seems we were happy to stick our heads in the sand and comfort ourselves with the ridiculous thought that cervical cancer could never happen to us.

When I called my friend from outside the Irish Family Planning Association clinic to tell her what I was about to do, she was in awe. "Really?" she asked, in a voice that suggested I'd just revealed my plans to scale the north face of Everest.

I should explain that the reason for my proximity to the dreaded speculum this week came about only because I made an appointment for a free medical screening through work. Not being a regular at the doctor's surgery, I thought medical screening meant someone tapping my knee with a hammer to test the old reflexes, and maybe someone else putting me on a scales and suggesting I lose weight. But apparently these medical screenings are a tad more thorough. "You'll be having your smear test and your breast exam as part of the screening," said the nice woman on the phone in a suspiciously breezy voice. She might have been talking about the weather.

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I spent the rest of the day under a cloud. I had managed to get off the phone without committing to the cervical part of the screening, but the niggling knowledge that I was playing Russian roulette with my health wouldn't go away.

I checked the statistics the way I had two years ago. Each year in this country there are 200 new cases of cervical cancer. Each year 70 women die from the disease. If caught early, it's entirely preventable. Screening saves lives.

I asked around. I suppose I was looking for someone to say: "You know what? This smear-test lark is actually quite enjoyable." Nobody did. "Of course it's not the nicest thing in the world," they said. "Nobody looks forward to it. You just have to endure it," they said. "Yes, it's uncomfortable. The speculum is always really cold. But you just grin and bear it," they said.

My first thought was that I am not good at grinning and bearing it. My second was: Could they not heat the thing up in this day and age? "You don't want to get burnt," the wonderful female doctor deadpanned at my suggestion.

Before I could protest any more, the "ordeal" was over and I was feeling silly about how much of a fuss I had made. It turned out that, taking into account my nerves, the good doctor had used a speculum that she confided was normally reserved for people who had never had sex. But I don't care. I still feel it was a huge personal achievement, mini-speculum or no mini-speculum.

I thought about it as I cycled back to the office. About how screening saves lives. It's a fact that makes it even more galling that, although plans are in place, the Government has yet to roll out a national cervical-screening programme. This means cowardy custards like me and my friend have zero incentive, not even the occasional conscience-pricking letter, to encourage us to get tested. It also means that without a friendly reminder from the health authorities, women who put their regular screenings on the long finger, or just forget about it because of their busy lives, increase their risk of dying from cervical cancer.

It's a disease that has a long pre-cancerous phase, and this is why a proper screening system is vital. In this paper's health supplement a few months ago, my colleague Elaine Edwards quoted a consultant obstetrician. "A woman in Ireland who gets cervical cancer has a higher chance of dying from it than a woman in England who gets it," he said. Something to think about when the politicians start appearing on the doorsteps. I feel more grown-up already.

roisiningle@irish-times.ie