Before starting my role as NHS England’s South Regional Medical Director I spent my career working as a gynaecologist. I fully support and endorse Cervical Cancer Prevention Week (January 22-28).
Cervical cancer treatment has been revolutionised since I started my career and we are now able to save many more lives than in the past. One of the major advances has been to understand the cause of cervical cancer better. A number of wart viruses (human papilloma virus “HPV”) are known to cause changes in the cervix which, if left untreated, can become cancerous over time. The cervical screening programme, originally set up in 1988 and often referred to as “the smear test”, detects these precancerous changes. These can usually be treated simply and quickly. Once treated, the risk of developing cervical cancer is extremely small.
Increasing the number of women who undergo cervical screening is vital. By identifying and treating precancerous changes we have the chance to further reduce the number of women who develop and then require treatment for cervical cancer.
The screening test is simple, quick and is performed by the Practice Nurse at your GP Surgery. 95% of results will be completely normal, and an invitation for a further test will be offered as part of the programme at a future date.
If the screening test is not normal, women will be referred to see a specialist. After assessment, the majority of women will not require treatment. If treatment is recommended, this can usually be performed easily in the clinic.
Every day 9 women in the UK are diagnosed with cervical cancer and 3 women will lose their lives to the disease. Cervical cancer is the most common cancer in women under 35 but is largely preventable thanks to cervical screening and the HPV vaccination programme.
But, statistics show that the number of women aged 25-29 years of age being screened for cervical cancer is the lowest in any age group and numbers attending for screening are falling year on year. Surveys undertaken by cancer charities indicate embarrassment and a lack of understanding of the causes of cervical cancer may be behind the fall in numbers attending.
The number of women dying from cervical cancer has halved over the past 28 years as a result of the NHS screening programme as well as improvement in treatment.
Despite this success over 3,000 women are diagnosed with cervical cancer each year. The majority of women diagnosed with cervical cancer have delayed coming forward for screening which has impacted on their ability to have early changes treated.
Worryingly, we have seen a decrease in women taking up screening in recent years across all age groups.
The reasons women often give is that they are too busy with their work and their family to make time. As carers they so often put everyone else before themselves.
Research by cancer charities has also shown that women do not understand the symptoms of cervical cancer and many find the process embarrassing.
I can fully understand lack of time and embarrassment but what I want to say to every woman who works for NHS England is that making time to take up your screening appointment is the single most important thing you can do for yourself and your loved ones as you are taking an active step to avoid developing cancer.
NHS England is one of 20 organisations that have signed up to the Jo’s Cervical Cancer Trust ‘Time to Test’ pledge demonstrating commitment to raising awareness of cervical cancer prevention in the workplace and ensuring female employees can access cervical screening. The pledge states:
The health of our employees comes first and if employees cannot make appointments out of working hours, we will find a way to make sure they can attend cervical screening, even if it means doing so during their working day.
And yes, it may be embarrassing, but staff are trained to understand how you feel and ensure you are treated with respect and dignity. You can also ask for a woman to perform the procedure when you go to your GP practice.
I ask every woman who works for us to take up the opportunity for screening when you are contacted. And I ask every member of staff to think of their sisters, daughters, mothers and female friends – encourage them to have the test and to spread the word that cervical screening is important.
Whilst cervical screening can reduce the number of women who develop cervical cancer, for teenagers the future is even more encouraging. Because we now know that certain types of wart virus (HPV) cause cervical cancer, a vaccine has been developed which can protect girls from most of these. The vaccine is offered to schoolgirls in Year 8 and is another important step in reducing the number of women who develop cervical cancer.
Across the South of England we will be raising awareness in the media and through social media – look out for #CervicalCancerPrevention and retweet. Perhaps by talking about it more we can reduce the embarrassment factor and help women to realise that screening is a normal part of looking after themselves.
I also ask colleagues who have patient contact to make Every Contact Count by using the awareness week as an opportunity to gently remind women how important screening is.