Let’s talk about...cervical screening uptake and inequalities in Scotland

Each year in Scotland, there are 323 diagnoses of cervical cancer and sadly 95 deaths.

Cervical cancer is largely preventable, thanks to the HPV vaccine and cervical screening (smear tests). Unfortunately, uptake of cervical screening is dropping and the lastest data from Public Health Scotland shows that just 68.7% women and other people with a cervix are up to date with this life-saving test – this is the lowest coverage in Scotland since national reporting began almost 30 years ago.

While the average level of coverage across Scotland is almost 69%, some communities are receiving even less protection. In the most deprived areas, just 62% of eligible women and other people with a cervix have been screened recently. Just over half (53%) of 25-29 year olds are up to date and amongst 25–31-year-olds who have not received the HPV vaccine, this is even lower at just below 38%.

Tackling declining uptake is becoming essential as we are seeing inequalities widen.

Over the past three years, Jo’s have established a Cervical Cancer Prevention team in Scotland, where we work with communities with low cervical screening uptake. Our project focus is working to better understand, and develop interventions to address, the barriers that exist. We also deliver training to community leaders, healthcare professionals, and staff from a wide range of organisations, so that they can help raise awareness and support their communities with cervical screening.

Raising awareness of cervical screening

A key area for the team is working with young women living in areas of deprivation. Our work involves dispelling myths, including the belief that if you had the HPV vaccine in school you don’t need to have screening, and gathering insight on the barriers to screening and how we can reduce barriers. Through our focus groups we have been told about a range of factors including getting childcare, difficulty getting time off work, fear and embarrassment, previous bad experiences of screening and trauma following sexual violence. Our work includes delivering awareness sessions in partnership with community organisations to provide information on all aspects of cervical cancer and HPV, and how the HPV vaccine and cervical screening help prevent cervical cancer. We also run cervical cancer prevention training for staff and volunteers at groups across the country. This training informs attendees about cervical health, but also equips them to have conversations around screening, enabling them to share our potentially life-saving information with the women they encounter, and increasing the reach of our message. A further part of this work is sharing learnings for our community work with healthcare professionals to enable them to reduce barriers through their work too.

Partnerships

Partnerships are essential to our work and help us ensure our messages reach as many people as possible. Working with organisations including Home-Start and One Parent Families has been key in helping us reach women aged 25-29 in areas of deprivation.

Over the last year we have partnered with Glasgow City Football Club, working with their staff, players, and supporters on a range of initiatives including advertising in their programmes, and goal-side banners.

Another of our partnerships is with Enable Scotland where we work with women with learning disabilities to co-design resources that better meet the needs of these women. We’ve also been working closely with the Glasgow Times, to support their ongoing campaign to raise awareness of cervical cancer and screening.

Nationally we work closely with NHS colleagues to tackle inequalities in the cervical screening programme by inputting into Scotland’s new Equity in Screening strategy and the new Core Screening Standards. We are also working at NHS board level with health improvement and public health teams, providing input on the patient experience and partnering with individual Health Boards to develop projects to address inequalities in screening in their area, this includes engaging with ethnic minority and faith groups to deliver awareness sessions and focus groups sharing the importance of cervical screening. 

Ambition 

All of this work leads us closer to our vision of a future without cervical cancer. Scotland has the tools to achieve this – with effective screening and vaccination programmes – but we want to make sure that nobody is left behind. By working with women and healthcare professionals, we want to give everyone the information and support they need to attend screening, and help make the screening programme as accessible as possible. We’re also calling for government strategies that ensure everyone has equal opportunities to reduce their risk of cervical cancer. 

Cervical screening saves lives, but we know that it isn’t easy for everyone.

For more information, tips, and support please visit: https://www.jostrust.org.uk/get-support