Cervical Cancer Week - Guest Blog from Jo's Trust
With one in five women failing to take up their cervical screening invitation Cervical Screening Awareness Week (15-21 June) is an opportunity to shine a spotlight on this life saving test. Last year on average one in five UK women who were invited to attend cervical screening did not have the test.
Jo’s Cervical Cancer Trust, the UK’s only dedicated cervical cancer charity, is concerned that cervical screening uptake is in decline; in England uptake for all women of screening age is down from a high of 82.5% in 1998 to 77.8% in 2014. Women within the first and last screening age groups show the most marked decline, with uptake for 25-29 year olds down from 78.8% to 66.3%, along with the lowest uptake for at least seventeen years for women aged 60-64 where 26.8% currently fail to attend. Overall uptake across the UK is similar; Scotland 77.3%, Northern Ireland 77.3% and Wales 78.6%, therefore on average there remains over 20%+ of women not attending. Lives are almost certainly at risk as a result.
A report we commissioned in 2014 with independent think tank Demos, showed that if we can get screening uptake to 85%, in just one year there would be a 14% reduction in incidence, and in five years a 27% reduction in deaths. This would also result in huge financial savings for the NHS, state and individuals. If 100% attended annually, incidence could decrease by 35% in just one year and deaths would halve over five years. These are powerful numbers but we must do more to get as many women as possible to access the screening programme.
Research by the charity shows that barriers to screening vary across age, ethnicity, where a woman lives and her social status. Cervical Screening Awareness Week (CSAW) takes place from 15-21 June and is an opportunity to run campaigns, display the charity’s literature, and put cervical screening on the agenda.
While the charity continues to be concerned about young women ignoring screening, it wants to use this year’s CSAW to focus on older eligible women. For women aged over fifty screening uptake drops off as they approach 64 to reach a low of 73.2% for the last screening cohort (60-64). This is a marked drop from a peak of 78% in 2007.
There are many factors to take into consideration for why older women may not attend screening. Some consider themselves not to be at risk if they have not been sexually active for a number of years. Others are focused on more pressing medical issues rather than prevention. Some find the test more painful as they have grown older or after the menopause. A survey by the charity has found a lack of knowledge around the causes with almost two thirds (60%) unaware that the main cause of cervical cancer is HPV (the humanpapilloma virus).
In the survey to 1,500 women aged 50-64 29.1% of women found the test painful since growing older, including 24.4% experiencing pain since going through the menopause. When asked about the relation between sexual activity and cervical cancer, 38.4% agreed or didn’t know if a woman is at risk of developing the disease if they have been with the same partner for over five years. It’s crucial that women realise that even if they have only had one partner they are at risk of having the virus, which can lay dormant for many years and may develop into cervical cancer if preventative steps aren’t taken. This lack of knowledge is particularly concerning as 31.1% of those questioned said they had had a new sexual partner in the last 20 years including 10.1% in the last 10 years and 8.2% in the last five years increasing their risk of being exposed to new high risk HPV which can cause cervical cancer.
Barriers to screening must be urgently addressed but other methods for testing must also be explored, for example a HPV self-sampling test. The numbers in our research reinforce this view. 53.6% of women who have delayed a cervical screening test said they would prefer to self-sample at home. This compares to only 20.5% of those that haven’t delayed screening historically.
In regards to survival rates, improved recognition of symptoms that are acted upon is crucial for early diagnosis and better outcomes. The charity’s research shows that a third more women would visit the doctor with a cold that lasted more than three week, than they would if they experienced abnormal vaginal bleeding. Furthermore 52% of women could not identify abnormal bleeding as a symptom of cervical cancer and of those that have experienced this, 48% did nothing about it. This low awareness of symptoms indicates that more needs to be done to help focus our campaigns and information provision.
The charity’s ambition is to drive prevention and ensure early diagnosis so that this disease can eventually be eradicated. Until we get to this goal our aim is to see that no woman dies from cervical cancer. We believe this will be achieved through continuously improving screening opportunities for all women, enhancing the messaging on the importance of screening, targeting those women who do not take part in the screening programme and raising awareness of symptoms.
The prevention programmes – screening and vaccination – are in place. Uptake for vaccination is positive and increasing year on year. The charity’s challenge now is to reverse the downward trend of screening uptake through education and awareness, and work with women and health experts to understand how we can better communicate with those of screening age and improve access to services. For change to happen, we need commissioners to look at the make up of their own communities and run targeted relevant campaigns.
Together, with the support of those who provide screening and immunisation services, we can potentially reduce the number of women diagnosed with cervical cancer from 1000s to only 100s in the not too distant future and eventually see the eradication of the disease.
For more information on Cervical Screening Awareness Week and Jo’s Cervical Cancer Trust visit www.jostrust.org.uk. The charity’s national helpline can be reached on 0808 802 8000.
Part of the BIVDA Guest Blog Series
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