Demy Hulshorst was 21 when she went to the doctor with a lot of bleeding. She turned out to have HPV, a virus that can sometimes develop into cervical cancer. In the Netherlands, women are invited for an HPV smear test when they are 30. But according to Demy and her fellow student Charell, that age should be lowered.
The now 23-year-old Demy tells RTL News that the virus came completely unexpectedly for her. “I was experiencing bleeding in between my normal periods,” she explains. “At first I thought it was because of my IUD, so I didn’t look any further. After a year, the doctor did a smear test and then I found out it was HPV. I was very shocked by this.”
Almost everyone gets HPV
HPV (Human Papillomaviruses) is a virus that someone almost always gets through sex. Almost everyone gets the virus at least once or more and the body usually clears the infection itself. Sometimes the body does not do this and a high-risk variant of the virus can cause cancer, including cervical cancer.
Demy turned out to have PAP level 3b. At that level, the cells are so abnormal that treatment is required. “I was then referred to a gynecologist,” says Demy. Since she is a young woman, she was advised to wait. This is because the treatment is often associated with unpleasant risks. “With a healthy lifestyle and when you are young, your body is often able to clear the virus itself,” she says. And that happened, because after a while she was at the lower level PAP 2.
Dutch women are invited for an HPV smear test as soon as they are 30 years old. Demy wants that age to be lowered to 25 years. That is why she and her fellow student Charell Meijer (22) started a campaign with the petition ‘HPVetkut’.
The fact that the body almost always clears the virus itself is not sufficient for Demy and Charell. “What happens to those young women who are not among the lucky ones?” they write in a press release. Demy adds: “If I look at myself, it could have developed further into cancer, perhaps a smear test at the age of 30 would have been too late.”
Gynecologist Ruud Bekkers from the Catharina Hospital Eindhoven explains that, for various reasons, women are only called for a smear test from the age of 30. “One in four women under the age of 30 is HPV positive, while only a very low percentage actually develop cancer.”
He continues: “Of the women with cervical cancer, 6 percent are under the age of 30. In total, this was fifty women last year.” Due to the recent vaccination campaign, he expects that this number will ‘halve to 25 women next year’.
Bekkers also explains that HPV treatment is indeed associated with risks. “For women who still want to get pregnant, it can cause premature births and children with disabilities.” He explains that it is therefore necessary to carefully consider whether earlier testing for HPV is the best option. “One does not dare to wait for a serious preliminary stage. The woman then becomes restless, and so does the doctor. As a result, many women can be treated unnecessarily and that can be quite distressing.”
Unrest
Demy does not think that early detection will create much unrest. “I can ask all the questions to the gynecologist, I read it carefully. That way I know that the body can solve it itself. Then that fear will soon go away.”
She continues: “Knowledge is still very low among young women.” She and Charell therefore believe that young people should receive more information about HPV. “For example, through a campaign for women between the ages of 18 and 29 on TikTok or Instagram about the symptoms and when to go to the doctor.”
Testing and vaccination are important
For gynecologist Bekkers, vaccination and testing at the age of 30 is of great importance. “Currently, 50 percent of women have the HPV smear done at the age of 30. And with the HPV vaccination in girls, 90 percent of cervical cancer is prevented before the age of 30. So let’s first ensure that all women aged 30 participate with the test and that young girls are vaccinated.”
There are countries where smear tests are done earlier. For example, in Norway, women aged 25 and over are advised to take an HPV test. “We have been using this age for 25 years, since 1995,” explains Ameli Tropé, gynecologist and head of the cervical program in Norway. “We don’t treat everyone who is HPV positive. Some specific HPV types we don’t treat and for other HPV types we wait three years and then retest. We only try to weed out those at higher risk of cancer.”
Demy is doing well at the moment. She still suffers from bleeding, but is monitored regularly. “I am checked every few months. Then I am there on time.” Demy and Charell hope to set something in motion with the campaign. “We want to set something in motion. The most obvious option is to go to the House of Representatives with our petition.”
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