Brighton and Hove has the lowest take up rates for cervical screening in the south east. Screening rates fall to a 20 year low across the UK.
Every day 9 women in the UK are diagnosed with cervical cancer and 3 women will lose their lives to the disease. Cervical cancer is the most common cancer in women under 35 but is largely preventable thanks to cervical screening and the HPV vaccination programme.
But, statistics show that the number of women aged 25-29 years of age being screened for cervical cancer is the lowest in any age group and numbers attending for screening are falling year on year.
This year the first girls who were vaccinated against HPV are also eligible for screening as they reach their 25th birthday.
Surveys undertaken by cancer charities indicate embarrassment and a lack of understanding of the causes of cervical cancer may be behind the fall in numbers attending*.
The number of women dying from cervical cancer has halved over the past 28 years as a result of the NHS screening programme as well as improvement in treatment.
Despite this success over 5,000 women are diagnosed with cervical cancer each year. Some of these women may have delayed coming forward for screening for a variety of reasons but treatment of early changes detected by screening can prevent women from developing cancer.
Dr Max Kammerling, Consultant in Public Health Medicine and Head of the Public Health Screening and Immunisation Team for Surrey and Sussex, said:
“It is really important for young women to understand the importance of attending cervical screening as it can detect pre-cancer abnormalities, which, if left untreated, may develop into cancer. Screening is for people without symptoms as a preventative measure.
“The screening test is relatively simple, takes about 5 minutes and is performed by the practice nurse at your GP surgery. 95 per cent of results will be normal and of those that are not, the vast majority can be treated very easily and will never develop in to cancer.”
NHS England and Public Health England are supporting Cervical Cancer Prevention Week which runs from January 22-28. The week aims to raise awareness of the importance of cervical screening and its role in preventing cancer, as well as encouraging women to go for their screening test when invited. NHS England’s screening and Immunisation teams also work with GP practices to increase awareness.
Dr Kammerling added: “We have noticed a fall in attendance of younger women over the past few years, and are concerned that this trend may increase due to misunderstanding of the level of protection that the HPV vaccination offers. Although they are protected against the two most common HPV types that cause 70% of cervical cancers, the risk is not completely eliminated and screening is still an important part of preventing cancer.”
Robert Music, Chief Executive Jo’s Cervical Cancer Trust, said:
“Cervical cancer is largely preventable with cervical screening (smear tests) providing the best protection against the disease. Screening prevents up to 75% of cervical cancers yet the number of women attending is at a 20 year low in England with over 1 in 4 women in Brighton and Hove missing their test in the last year.
“There are many reasons women don’t attend ranging from simply putting it off to worrying it will be embarrassing or painful to not knowing what the test is and why it’s important. During Cervical Cancer Prevention Week we want to encourage women to talk to their friends, mothers and daughters about the steps they can take to reduce their risk of cervical cancer.”
NHS England has signed up to the Jo’s Cervical Cancer Trust ‘Time to Test’ pledge demonstrating commitment to raising awareness of cervical cancer prevention in the workplace and ensuring female employees can access cervical screening. The pledge states:
The health of our employees comes first and if employees cannot make appointments out of working hours, we will find a way to make sure they can attend cervical screening, even if it means doing so during their working day.
Women can reduce their risk of cervical cancer by:
- Practicing safe sex. Condoms can help reduce the risk of being infected with HPV
- Not smoking – The risk of developing cervical cancer if you are a non- smoker, on average, is half that of a woman who is smoker
- Attending cervical screening when invited: this can help to find cervical abnormalities and HPV infections before they are able to develop into cervical cancer.
- Vaccination: getting the HPV vaccination if you are eligible (for girls at school in Year 8) will protect you from the high-risk HPV types 16 and 18 that cause 70% off all cervical cancers.
A cervical screening test (previously known as a smear test) is a method of detecting abnormal cells on the cervix. The cervix is the entrance to the womb from the vagina.
Detecting and removing abnormal cervical cells can prevent cervical cancer.
Testing for abnormal cells
Cervical screening isn’t a test for cancer, it’s a test to check the health of the cells of the cervix.
Most women’s test results show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix.
Most of these changes won’t lead to cervical cancer and the cells may go back to normal on their own.
But in some cases, the abnormal cells need to be removed so they can’t become cancerous.
About 3,000 cases of cervical cancer are diagnosed each year in the UK.
It’s possible for women of all ages to develop cervical cancer, although the condition mainly affects sexually active women aged 30 to 45. The condition is very rare in women under 25.
The cervical screening programme
The aim of the NHS Cervical Screening Programme is to reduce the number of women who develop cervical cancer and the number of women who die from the condition.
Since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about 7% each year.
All women who are registered with a GP are invited for cervical screening:
- aged 25 to 49 – every 3 years
- aged 50 to 64 – every 5 years
- over 65 – only women who haven’t been screened since age 50 or those who have recently had abnormal tests
Being screened regularly means any abnormal changes in the cells of the cervix can be identified at an early stage and, if necessary, treated to stop cancer developing.
But cervical screening isn’t 100% accurate and doesn’t prevent all cases of cervical cancer.
Screening is a personal choice and you have the right to choose not to attend.
Your screening appointment
The cervical screening test usually takes around 5 minutes to carry out.
You’ll be asked to undress from the waist down and lie on a couch, although you can usually remain fully dressed if you’re wearing a loose skirt.
The doctor or nurse will gently put an instrument called a speculum into your vagina. This holds the walls of the vagina open so the cervix can be seen.
A small soft brush will be used to gently collect some cells from the surface of your cervix.
Some women find the procedure a bit uncomfortable or embarrassing, but for most women it’s not painful.
If you find the test painful, tell the doctor or nurse as they may be able to reduce your discomfort.
Try to relax as much as possible as being tense makes the test more difficult to carry out. Taking slow, deep breaths will help.
The cell sample is then sent off to a laboratory for analysis and you should receive the result within 2 weeks.
HPV testing
Changes in the cells of the cervix are often caused by the human papilloma virus (HPV).
There are more than 100 different types of HPV. Some types are high risk and some types are low risk. HPV-16 and HPV-18 are considered to be highest risk for cervical cancer.
After successful trials, HPV testing has been incorporated into the NHS Cervical Screening Programme.
If a sample taken during the cervical screening test shows low-grade or borderline cell abnormalities, the sample should automatically be tested for HPV.
If HPV is found in your sample, you should be referred for a colposcopy for further investigation and, if necessary, treatment.
If no HPV is found, you’ll carry on being routinely screened as normal. If your sample shows more significant cell changes, you’ll be referred for colposcopy without HPV testing.
In some areas, a test for HPV is the first test on the screening sample. In these cases, the sample is only checked for abnormal cells if HPV is found.
If HPV isn’t found, you’ll be offered a screening test again in 3 to 5 years (depending on your age).
