UPDATE (30 June 2017):
A new report shows that 1 in 4 women are “unaware” that cervical screening even exists. For more details, check out our blog here.
It has recently been confirmed that one in four women miss their smear test.
The article recently published by the BBC confirms that from around 4.2 million women invited, just over three million attended. NHS Digital commented that this was the second consecutive year that screening rates had fallen. Attendance rates in Wales and Scotland have also decreased.
But why is this important and why are women missing their smear tests?
What is a Smear Test?
A smear test is also known as a cervical screening test and it is a way of detecting abnormal cells on the cervix (the entrance to the womb from the vagina).
The test checks the health of the cells of the cervix and while most women’s test results confirm everything is normal some women are informed the test showed “abnormal changes”. Most of these changes will not lead to cervical cancer and the cells may go back to normal on their own. However, in some cases, the abnormal cells need to be removed so they cannot become cancerous.
NHS Direct confirm that around 3,000 cases of cervical cancer are diagnosed each year in the UK. It is possible for women of all ages to develop cervical cancer. Therefore the aim the smear test is to reduce the number of women who develop cervical cancer and the number of women who die from the condition.
During the smear test the doctor or nurse (one can have a chaperone present too) will gently put an instrument called a speculum into the vagina and then a small soft brush is used to gently collect some cells from the surface of the cervix.
The cell sample is then sent off to a laboratory for analysis and the results should be returned within two weeks. If you do not hear back with the test results it is advised that you telephone your GP or health service provider to find out.
Why is screening important?
The simple answer is because it saves lives. By detecting and removing abnormal cervical cells can cervical cancer can be prevented.
This involves regular screenings so that any abnormal changes in the cells of the cervix can be identified at an early stage and, if necessary, treated to stop cancer developing.
However, cervical screening is not 100% accurate and does not prevent all cases of cervical cancer. The symptoms of cervical cancer are not always obvious and it may not cause any symptoms at all until it has reached an advanced stage. This is why it is best to attend the screening appointments rather than waiting until symptoms develop.
Jo’s Cervical Cancer Trust chief executive Robert Music discusses the recent statistics: “The new data makes bleak reading. If we do not start to immediately reverse declining coverage, then tragically we will see more diagnoses and lives lost from what is a largely preventable disease.”
Why are women not attending screening appointments?
There are in fact two issues here:-
1. Women who are not registered with a GP to receive notification their smear test is due.
It is thought that there are hundreds of working women who move house and who often are not registered with a GP, which is a requirement before a smear test. This means some women miss the letter notification calling them for their smear test and can go years without having one.
2. The non-attendance of women who are called in for screening.
Linked to the issue of missed screening appointments is the group of women who go on to develop signs and symptoms of cervical cancer, but who do not go to their GP for advice and treatment.
Below are some of the reasons why appointments are “missed” and I hope this blog has explained why the test is so important that these reasons can be overcome:-
- The test is felt to be unnecessary if a woman has only had one sexual partner. Experts explain this is incorrect and urge women to still have the smear test irrespective of how many sexual partners one has had.
- Embarrassment. It is embarrassing to some to discuss with a male or female GP (or family members) about the symptoms they are experiencing. Others find it embarrassing lying on a table waiting for the doctor or nurse to perform the smear test. Ultimately it is better to be healthy than feel embarrassed about a life-saving test which is free on the NHS.
- Fear that the procedure will be painful. In most cases it is mild discomfort and takes a couple of minutes to be performed. It can often be the anxiety and fear of not knowing what it will be like that is worse but with a caring GP or nurse your fears can be allayed.
- Being too busy to book an appointment or attend. In the busy hectic world in which we live, coupled with the fact it can sometimes feel difficult to obtain a convenient appointment, the smear test is one which can get postponed again and again.
- The fear factor. It is natural to be scared and afraid of receiving a result when the test is to screen for cell changes and ultimately a person is thinking of the word “cancer”. It is also scary for women experiencing symptoms such as unexplained bleeding and vaginal/internal pain to go to a doctor for fear of hearing it is something serious.
Given the issues above it is no surprise that Robert Music (the chief executive of Jo’s Cervical Cancer Trust) is asking the Government to introduce the option of self-screening and apparently this is being investigated. Self-screening would help the one in four women who currently miss their smear test have access to this important screening.
Additional Reading and Support
You can access Jo’s Cervical Cancer Trust online for information and support on smear testing and cervical cancer.
Our Hugh James medical negligence team sadly see cases involving the delay in diagnosis of cervical cancer and we represent victims or their families in these matters. Although cervical cancer in under 25 year olds is rare, these are often the cases which are missed by medical staff and young lives are lost.