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A bikini wax to fight cervical cancer? Here comes Julyna

A controversial new campaign designed to raise money and awareness for cervical cancer is instead drawing criticism from health experts who say it risks everything from objectifying women to sending inaccurate messages about prevention of the disease.

Julyna is a month-long campaign taking place this month that asks women to trim their pubic hair into a creative design and solicit donations for doing so from friends and family. By putting attention on a woman's pubic hair, the organization hopes women will become aware of cervical cancer screening and prevention.

The campaign, backed by the Canadian Cancer Society, was inspired by Movember, a month-long campaign during which men grow mustaches and receive pledges toward prostate cancer research.

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"Let's face it, it's a very crowded event market in Ontario and right across Canada and so events need to be unique to stand out," said Guy Laporte, director of Toronto revenue development at the Ontario branch of the Canadian Cancer Society.

But women's health experts are questioning the structure and focus of a campaign that links cancer to women's sexuality and seems needlessly risqué.

"I'm concerned about this one," said Joan Murphy, clinical lead for the Ontario Cervical Cancer Screen Program at Cancer Care Ontario and gynecologic oncologist in the Princess Margaret Cancer Program at University Health Network. "Shaving your pubes to any different shape, I don't think that's going to bring discussion around the water cooler."

Unlike Movember, which has become a worldwide phenomenon and raised millions in large part because of the visibility of mustaches, Julyna is largely invisible.

"Pubic hair … it doesn't have the, at least I hope it doesn't, have the visibility," she said. "I think this is going to miss that mark."

And instead of fostering acceptance of cervical cancer, Julyna risks undoing efforts to destigmatize a disease that has traditionally been associated with promiscuity. The main risk factor for developing cervical cancer is contracting human papillomavirus (HPV), typically transmitted sexually.

"I'm not sure this risqué campaign is going to help dig us out of that hole, frankly," Dr. Murphy said.

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Julyna organizers expected to receive some negative responses and say the point is to get people talking about a disease that is largely preventable.

"We knew it was controversial," said Jacqueline Blackwood, a Julyna committee member, but "there's no harm in raising more funds for further research or awareness, right?"

Yet, some question how a campaign centred on pubic hair can boost awareness of cervical cancer.

"How is one related to the other?" said Jane Shulman, director of knowledge exchange at the Canadian Women's Health Network. "I think it's really far from awareness-raising."

Meredith Dault, a graduate student at Queen's University studying the growing popularity of pubic hair removal, said a campaign that asks women to remove pubic hair, which can cause pain and cost money, objectifies what should be a private area. It's the "last area of commodification on the female body," she said.

Like Julyna, a growing number of charitable organizations are using gimmicks to attract attention to their cause, such as "I Heart Boobies" bracelets to promote breast cancer awareness or mustaches for prostate cancer.

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Gayle Sulik, a U.S.-based researcher and author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health, questions the sexualization and role of corporations in breast cancer charities and sees many parallels with the Julyna campaign. The use of lighthearted messages and sexual innuendo creates a muted version of awareness, exploits women's bodies and ignores the devastating impact cancer has on individuals and their families, Dr. Sulik argues.

"In short, I don't think that using trivializing strategies to increase visibility or funding is a viable approach in the long run for any disease," she said in an e-mail.

At the same time, Julyna's pubic hair campaign to encourage young women to get vaccinated or screened for cervical cancer risks sending inaccurate messages and ignores realities about gaps in prevention.

The Julyna website says women should get Pap smears every one to three years after becoming sexually active.

The advice is an oversimplification of current practice. Mounting evidence suggests annual tests are too frequent and can expose women to unnecessary or invasive follow-up exams. Depending on where a women lives and her age, she may go two to three years between screenings, or have a few annual screenings that become less frequent if the test results are normal.

The problem, Dr. Murphy says, is not that young girls are not getting Pap tests. "If anything, there's overscreening in the younger lower-risk population," she said.

Women who are not screened enough are often visible minorities, women with low levels of education and those from low-income backgrounds. It's unlikely those vulnerable populations will be part of fundraising initiatives such as Julyna. Older women also have low Pap test rates, Dr. Murphy said, an issue that's not addressed in a campaign aimed at young women.

While vaccinations guarding against certain types of HPV can have a major public health benefit, they are most effective in adolescents before they are sexually active. That means messages conveying the importance of HPV vaccines may be most effective if aimed at parents, many of whom remain leery about giving young girls a needle to prevent a sexually transmitted infection.

Wylam Faught, a gynecologic oncologist and chair of obstetrics and gynecology at the University of Ottawa and the Ottawa Hospital, said the provocative Julyna campaign may have a unique ability to reach young women, but could alienate others. But if they raise money, perhaps the ends justify the means, he said.

"I think it will be perceived by different audiences probably differently," Dr. Faught said. "Whether this is the right formula, that's a good question."

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