One in four women in Essex not adequately screened for Cervical Cancer

Women across Essex are being reminded to check they're up to date with their smear tests - as cancer charity calls for more to be done, during Cervical Cancer Prevention Week (23rd-29th January).

Author: Amy ShephardPublished 25th Jan 2023

Jo's Cervical Cancer Trust has called on the Government to commit to increased action to eradicate the disease, saying "the UK has the tools to get there".

Around 3,200 women are diagnosed with cervical cancer and more than 800 die from the disease each year in the UK.

The HPV vaccine has been routinely offered in schools to girls aged 12 to 13 since 2008 and to boys the same age since September 2019.

However, the charity said some women still struggle to access screening, citing falling screening rates.

The World Health Organisation (WHO) defines the elimination of cervical cancer as four or fewer cases detected per 100,000 women in any year.

In a report, the charity says barriers to success include a lack of understanding around the effectiveness of the current vaccination programme, anti-vaccine sentiment, inequalities in uptake of cervical screening, competing NHS priorities and workforce shortages affecting how the programme works.

Almost one in three women across the UK are not up to date with their cervical screening, "with screening coverage at its lowest level in 20 years", the report said.

Only 74.7% of women in Essex are considered to have been adequately screened.

Kate Sanger from Jo's Trust, says uptake of smear tests and HPV jabs are at a low in recent years, because of Covid:

"As a result of Covid, lots of people didn't go forward to the GP with health conditions or symptoms. And as a result we've seen cancer rates, including Cervical Cancer rates, rise among some groups.

"Screening is one of the best ways we can stop getting Cervical Cancer. And the earlier anything that might need to be treated is detected, the simpler the treatment and the much less impact it has on you. The later we leave these things, the more intensive the treatment is, and the longer the recovery.

"So by going to screening, you can literally stop yourself from getting cancer."

HPV vaccine in schools

The UK currently offers a human papillomavirus (HPV) vaccine in schools together with a cervical screening programme and colposcopy services that help catch pre-cancerous cell changes.

Around 13 high-risk types of HPV cause 99.7% of cervical cancers.

As a result of vaccination, cervical cancer has been almost eliminated in women born since September 1995, the Jo's Trust report said.

However, England data for the 2021/22 school year shows HPV vaccine uptake in girls and boys fell by 7% and 8.6% respectively from the previous year.

Coverage in England for girls receiving two doses by school year nine was just 67.3% - 20% lower than before the pandemic.

Meanwhile, in Wales, coverage of two doses of HPV vaccine in girls in the 2021/22 school year 10 was just 55.1%.

For its report, Jo's Trust surveyed 848 people working in the field, including nurses, clinical nurse specialists, biomedical scientists, radiographers and cancer specialists.

Most of those polled said offering women, including those who do not turn up for screening, the opportunity to take an HPV test at home is "one of the biggest opportunities to eliminate cervical cancer in the UK".

The report said the clinical accuracy of HPV self-sampling is high, but it may be less likely to pick up pre-cancerous changes to cells.

Other recommendations from those surveyed include more education about the HPV vaccine in schools and national awareness campaigns about HPV and cervical cancer; as well as swift action regarding the recruitment and retention of staff working in the field, including in labs.

Samantha Dixon, chief executive at Jo's Cervical Cancer Trust, said:

"A world without cervical cancer doesn't have to be a pipe dream.

"The UK has the tools to make it a reality, which is incredibly exciting.

"We need Government action to get there as soon as possible but everyone can play their part.

"Going for cervical screening when invited and making sure your child is vaccinated against HPV will help make cervical cancer a thing of the past."

A Department of Health and Social Care spokesperson said:

“A cervical cancer diagnosis can be devasting but we can reduce cancer rates by increasing the number of screenings that take place. We encourage anyone who is eligible to come forward when invited.

“We are taking action expanding the number of settings for screenings, opening up 24/7 laboratory screening so people get results faster, as well as making appointments available during evening.

“In 2021-22, three and a half million people were tested in England – an increase of nearly half a million compared to the year before.”

The Government is currently looking into the acceptability and effectiveness of HPV self-sampling (i.e. individuals take their own cervical screening sample) as a primary cervical screening option.

The "YouScreen" study aims to provide evidence on the acceptability of self-testing and is offering this test to non-attenders aged 25-64 and those at least 6 months overdue for cervical screening.

A second study - HPValidate - aims to see if self-testing provides the same level of accuracy as an HPV test undertaken by a clinician.

A spokesperson from the Department of Health and Social Care added:

"The findings from these studies will be used to inform a UK National Screening Committee recommendation on cervical screening.

"If the outcome proves positive, self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending for screening, including availability of appointments, physical disability and past trauma."