Of the more than 100 types of cancer, only three have screening programmes in the UK. Two are specifically for women, and only one is available for young women – cervical screening.
Just over 30 years ago, under the country’s first female Prime Minister Margaret Thatcher, the NHS Breast and Cervical Screening Programmes were introduced. They were the first of their kind in the world - a lifesaving step forward.
Although breast cancer remains the most common type of cancer in women in the UK – around one in eight women are diagnosed with breast cancer during their lifetime – significant investment in research means the number of women losing their lives to the disease has steadily decreased over the last two decades.
Cervical cancer, meanwhile, is one of the five gynaecological cancers, along with ovarian, womb, vulval and vaginal. Together, they are the fourth most common cancer affecting women. In 2009, after two decades of cervical screening in the UK, incidences of cervical cancer had halved.
But recent findings show the number of women attending screenings are at their lowest since 1997. Significantly, only 69% of younger women attended their screening within six months of receiving the invitation – meaning one in three women are not taking up the invite.
Unlike breast cancer, where more than 80% of cases occur in women over 50, cervical cancer is the most common cancer in women under 35.
In March, it will be a decade since Big Brother star Jade Goody died of cervical cancer, aged just 27. Jo’s Cervical Cancer Trust says her death on Mother’s Day that year, leaving behind two young sons, sparked a surge in requests for smear tests with an extra 400,000 women attending a screening. Sadly, the charity admits ‘the Jade Goody effect’ is long gone. Once again women my age are putting the test off, believing it won’t affect them.
It’s something which even family favourite Call the Midwife will be tackling in the latest series; the actress Helen George has told interviewers she is hoping a storyline featuring London’s first smear tests will raise awareness of the issue and trigger another screening surge.
My colleagues in Parliament are also working to highlight the fact screening is at a 21-year low. During Prime Minister’s Questions this week Redditch MP and Conservative Rachel Maclean asked Theresa May to support calls for women to take up their screening invitations, after her own routine screening picked up abnormalities which, if left untreated, could have developed into something much more serious.
What followed could not be replicated in many parliaments around the world: a Prime Minister talking about her own experiences of smear testing and encouraging other women to be tested, despite any ‘discomfort or embarrassment’, as ‘those few minutes can save lives’.
At age 29, I have already had four smear tests – Scotland’s previous age limit was 20, though the devolved government raised it to 25 in 2016 in line with the rest of the UK. While cases such as Jade Goody’s lead to continued debate on whether this should be re-considered, evidence has also shown screening women under the age of 25 can lead to unnecessary and harmful investigations and treatments.
But I have never sought to delay, miss or ignore an appointment; the brief discomfort I experience is a small inconvenience compared to what could be devastating consequences of a cervical cancer diagnosis.
Elimination of the disease is already on the horizon in Australia, through a combination of updates to its screening programme and the introduction of a Human Papilloma Virus (HPV) vaccination scheme in 2007. Last year three-yearly routine pap smear tests were replaced with five-yearly HPV cervical screening tests; estimates suggest they are more sensitive and reliable, and could reduce cancer rates by at least 20%. HPV primary screening is in use in some areas of the UK already and, as part of the NHS Long-Term Plan, will be rolled out across the whole of England by next year.
The Plan commits to dramatically improving cancer survival over the next ten years, partly by increasing the proportion of cancers diagnosed early. Cervical cancer may be the most common cancer in women under 35, but early diagnosis of cell changes through screening can prevent 99.8% of cases from developing further.
The next time the reminder letter slips through the postbox, don’t put it at the bottom of the pile. Cervical cancer can and does affect anyone, but doesn’t need to be a killer. You owe it to yourself – and your friends and family – to pick up the phone and make that appointment. It could literally save your life.