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Women in England are ignoring their first and last cervical screening invitation putting their lives at unnecessary risk

Mon, 10/06/2013 - 01:00

The UK’s only dedicated cervical cancer charity is today urging women in England to have regular cervical screening tests from first to last invitation after the most recent figures(1) for cervical screening uptake in England show worrying trends for both young and older women.

For those aged 60-64 uptake of the cervical screening invitation is now at a 15-year low whilst for those who are due their first invitation, one in three will ignore or delay their invite. With these worrying figures, Jo’s Cervical Cancer Trust is concerned the trend could lead to an increase in incidence levels and is using Cervical Screening Awareness Week (June 9-15) to warn women they may be putting their lives at unnecessary risk.

In recent years uptake for cervical screening in the 60-64 cohort has fallen dramatically to 72.7% in 2012, a drop of 5.3% from its peak in 2007 and is now at a 15-year low. When coupled with reports pointing to a rise in women having new relationships later in life, this may increase her risk of being exposed to the human papillomavirus (HPV), which is the cause for over 99.7% of cervical cancers.

For younger women aged 25-29 who may be due their first test, only 63% attended screening in 2012. The poor uptake is particularly worrying in this age group because cervical cancer is the most common cancer in UK women under 35.

Robert Music, Director of Jo’s Cervical Cancer Trust, says: “Cervical cancer is a largely preventable disease thanks to the cervical screening programme, so we are extremely worried about this trend where women are ignoring their first and last invitation as this could potentially lead to an increase in women diagnosed with the disease.

“Recent reports(2) point to an increase in women having new partners’ later in life and this will increase their risk of contracting HPV. However, even if this is not the case, typically cervical cancer is a slow growing cancer which usually takes 10 to 15 years to develop, so women who have not been sexually active for some time may still be at risk.

“We are equally concerned about young women as those aged 25-29 represent the lowest attendance for screening. It’s absolutely paramount that women take up their first invitation as early stage cervical cancer, in the majority of cases, is symptomless. In the best case scenario cervical screening is designed to detect abnormal cells before they turn cancerous saving a woman from going through invasive treatment with devastating consequences. Whilst it can prevent cervical cancer developing screening also plays a vital role in catching the disease as early as possible, improving survival rates.”

Professor Kevin Fenton, Director of Health and Wellbeing, Public Health England commented: “Regular cervical screening is the best way to detect changes to the cervix before cancer develops. Women at both ends of the eligible age range can benefit, as early detection and treatment of abnormalities in cervical cells can prevent cancer from developing. Research suggests that up to 4,500 lives will be saved each year in England by cervical screening.”

Research* by the charity has shown that almost a third of women aged between 50 and 70 believe the test to be unnecessary and irrelevant to them, whilst single, separated or divorced women are more likely to have never been for a screening compared to those who are in a relationship. Furthermore 69% were unsure that HPV was the main cause of cervical cancer.

Robert continues, “The charity’s research has given us cause for concern which has been compounded by NHS data(3) which shows that 55% of women aged 50-64 with fully invasive cancer had not been screened for at least seven years prior to their diagnosis, compared to only 17% of the general population.

“Where older women feel it is irrelevant for them to attend, in contrast studies** show very different reasons that younger women do not attend. These include embarrassment, fear of the procedure after finding a previous test painful as well as finding it difficult to book a screening appointment due to a busy working schedule.”

Jo’s Cervical Cancer Trust is now running a UK-wide awareness campaign to encourage women of all ages to take up their cervical screening invitation. Adverts will appear in washrooms in shopping centers, motorway service stations, bars, pubs and clubs during Cervical Screening Awareness Week. In London, where uptake is the poorest in England (74.1%), there will be adverts appearing in underground stations for two weeks in June. The charity is also sending information packs to 6,000 GP surgeries across the UK which includes information, posters and leaflets on cervical screening.

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

Research by Jo’s Cervical Cancer Trust found:

*Of 50-70 year old women surveyed (1):
• 31% didn’t consider screening necessary for all women with that figure more than doubling (67%) amongst those who had never attended screening.
• 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

(1) 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. The figures have been weighted and are representative of all UK females aged 50 to 70

**Of those aged 25-34 surveyed:
• 43% said they had missed or delayed a screening
• 43% found the procedure embarrassing
• 26% said they found the procedure painful
• 22% missed an appointment and failed to reschedule one
• 27% said it was hard to book a cervical screening appointment at a convenient time

*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.

Notes to editor:
• Jo’s Cervical Cancer Trust – (www.jostrust.org.uk). For the charity's national helpline call 0808 802 8000
• 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.
• Cervical cancer is the most common cancer in women in the UK under 35
• 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.
• Cervical cancer is predominantly caused by the human papillomavirus (HPV) which can be caught as soon as you start having intimate relationships.
• HPV is a very common virus. Up to 80% of individuals will be infected with a genital HPV at some time during their lives.
• You are still at risk of contracting HPV even if you do not have penetrative sex as the virus is transmitted through genital skin-to-skin contact.
• Public Health England is a new executive agency of the Department of Health that took up its full responsibilities on 1 April, 2013. PHE works with national and local government, industry and the NHS to protect and improve the nation’s health and support healthier choices and will be addressing inequalities by focusing on removing barriers to good health. To find out more visit their website www.gov.uk/phe or follow them on Twitter @PHE_uk.

About cervical screening in England:
• In England women aged 25-49 are invited to attend screening every 3 years, whilst those 50-64 are invited every 5 years
• In 2012 the UK National Screening Committee recommended a uniform screening age of 25 to 64 across all UK countries. These changes are due to be implemented in Wales from 1st September and Scotland from 2015.
• In 2012 78.6% of eligible women took up their cervical screening invitation. This compares with 81.6% in 2002
• London has the lowest take up at 74.1%

(1) The NHS Cervical Screening Programme Bulletin, 2011-12, published October 2012
(2) The FPA’s ‘Middle Age Spread’ campaign in 2010 highlighted an increase in new relationships for women over 50 http://www.fpa.org.uk/campaignsandadvocacy/sexualhealthweek/
(3) NHSCSP Audit of Invasive Cervical Cancer, 2007-2011, published May 2012