Cervical screening uptake in England faces ten year low

Jo’s Cervical Cancer Trust calls for more women to have the life saving test

The UK’s only dedicated cervical cancer charity has launched a targeted UK-wide campaign to mark national Cervical Screening Awareness Week (10-16 June) and to urge more women to attend cervical screening as statistics show a worrying downward trend which point to uptake being at a 10 year low in 2012.

With the exception of a dramatic rise in 2009 following Jade Goody’s battle with cervical cancer, since 2002 figures have declined year on year culminating in a 3% drop in screening uptake to 78.6% over the past 10 years. This means that more than one in five women between the ages of 25 and 64, and one in three aged below 35 are not taking the opportunity to combat a largely preventable disease. For women over 50 screening uptake dropped below 80% in 2010 for the first time and fell even further in 2011.

Robert Music, Director of Jo’s Cervical Cancer Trust, the UK's only charity dedicated to women and those close to them affected by cervical cancer and cervical abnormalities said: “Every day eight women are diagnosed with cervical cancer and three lives are lost to the disease. Cervical screening can help reduce these numbers. The screening programme saves 5,000 lives each year in the UK yet 20% of women are not attending their cervical screening test. The more we can do to stress the importance of this life saving test the better.

“With such a worrying decline in numbers, our campaign is also targeting key cities where uptake is below the national average. Adverts urging eligible women to get screened will adorn buses across London, Birmingham, Cardiff, Glasgow and Manchester reaching a potential 5.5million people.”

Research conducted by Jo’s Cervical Cancer Trust highlighted several barriers to women attending their cervical screening test. A number of women cited that they didn’t feel screening was a necessary test or relevant to them, many found it hard to understand the information they received whilst a lack of awareness about the causes, symptoms and ways to prevent cervical cancer all came to light through three surveys targeting women of screening age, the over 50’s and BME communities.

A survey looking at barriers in the workplace also showed some women found it difficult to arrange an appointment for screening around their busy work schedules whilst more flexibility from GPs around appointment times would encourage them to make it more of a priority.

“It appears that more and more women every year are putting off getting screened for a multitude of reasons” said Robert. “These women are not getting the right support and information or they are simply not being reached at all. This is particularly true of BME communities where we see a greater lack of awareness which may lead to fewer numbers being screened compared to white women. This is something that needs to be urgently addressed.

“Another major contributing factor to women not attending is embarrassment and fear of the procedure. We want to reverse this trend by reassuring those who are nervous about the test that it’s a simple five minute procedure that could save their life.”

In the over 50 cohort NHS data shows that numbers of women with fully invasive cancer hadn’t been screened within 7 years of diagnosis.

“Older eligible women need to be aware that cervical screening is not just for the young and it’s worrying to see the figures for uptake are even lower for women over 50.

“It’s clear that a job needs to be done for more targeted campaigns to reach individual groups of women with the relevant information and reassurance that will encourage them to attend.”

For further information contact Maddy Durrant, Jo’s Cervical Cancer Trust on 020 7936 7498 / 07772 290 064 or email [email protected]

Further information

Issues around GP and employer flexibility*
• 39% of women of screening age who work and have missed or delayed appointments said they didn’t find it easy to leave work in order to attend cervical screening appointments
• Only 16% of women of screening age that have missed or delayed appointments said their GP surgery offers screening appointments in evenings or weekends which has made it easier to attend
• 30% aged 25-34 that have missed or delayed appointments and work always book holiday to attend appointments as they were too embarrassed to talk to employers
• Over a quarter (26%) of women of screening age who work and have missed or delayed appointments would be more encouraged to attend if their company was more flexible and they didn’t have to take holiday for an appointment.
• 29% of women of screening age who missed or delayed screening felt that making an appointment at a convenient time was difficult

*From YouGov Plc. Total sample size 2718 women of which 2467 were of screening age. Women aged 20+ in Scotland and Wales and 25+ in England and Northern Ireland. Fieldwork undertaken between 7th and 10th January 2011. The survey was carried out online.

Differences between BME and white women*
• 1/3rd more BME women of screening age (12%) compared to white women (8%) said they had never attended a cervical screening appointment.
• 70% of Asian women aged 20-65 knew that screening is a test to check cells from the cervix to find pre-cancerous abnormalities against 91% of white women aged 20-65.
• 53% of BME women aged 55-65 think screening is a necessary health test against 67% of white women aged 55-65
• Almost half (45%) of white women would be comfortable talking to a male GP about cervical screening but only 28% of BME women agreed.
• Twice as many BME women as white women said better knowledge about the test and why it is important would encourage them to attend (30% against 14%)

*From YouGov Plc. Total sample size was 1179 white women and 1177 BME women aged 20-65. Fieldwork undertaken between 30 June – 7 July 2011 The survey was carried out online.

Of 50-70 year old women surveyed*:
• 31% didn’t consider screening necessary for all women with that figure more than doubling (67%) amongst those who had never attended screening.
• 68% were unaware that the main cause of Cervical Cancer is HPV
• Single women aged 50 to 70 were most likely to say the screening invitation seemed irrelevant (5%).
• Only 33% said the information they received was informative and less than half (49%) thought their screening invite made it clear why the test is important
• 37% said they would be more likely to book a screening appointment if they were given age-relevant information

*From YouGov Plc. Total sample size was 2397 women aged 50 – 70. Fieldwork undertaken between 16 and 21 December 2011 The survey was carried out online.

Notes to editor
1. Jo’s Cervical Cancer Trust – (www.jostrust.org.uk). For the charity's national helpline call 0808 802 8000
2. Around three women in the UK die each day from cervical cancer, with someone being diagnosed every three hours, facing an uncertain future. Over 300,000 women a year are told they may have a cervical abnormality that could require treatment.
3. It is estimated that the UK Cervical Screening Programmes save 5,000 lives every year and if HPV vaccination take up continues to reach at least 80% it is believed this could result in a 2/3rds reduction in incidence in women under 30 by 2025.
4. Cervical cancer is predominantly caused by the human papillomavirus (HPV) which can be caught as soon as you start having intimate relationships.