Cervical Cancer - Screening Matters
March 2008 celebrated the 20th anniversary of both the breast and cervical screening programmes in the UK. During the last two decades there has been great progress in both prevention and early detection of cervical cancer. But, if more lives are to be saved, it is essential to continue making improvements to the screening programme and encourage women to attend screenings when invited.
By Dr Lesley Walker
March 2008 celebrated the 20th anniversary of both the breast and cervical screening programmes in the UK. During the last two decades there has been great progress in both prevention and early detection of cervical cancer. But, if more lives are to be saved, it is essential to continue making improvements to the screening programme and encourage women to attend screenings when invited.
The cervical screening programme is saving thousands of lives each year and prevents around 75 per cent of cervical cancers from developing. Cervical cancer is the second most common cancer in the world. But, in the UK, thanks to the screening programme, it has dropped down to twelfth place.
Such success, combined with the latest weapon in the arsenal, the HPV vaccine, could give the impression that all bases are covered in the fight against cervical cancer.
But Cancer Research UK is warning against complacency. The HPV vaccine will not benefit the majority of women because it is being given to girls aged 12 – 13 years old. And the vaccine only protects against certain strains of HPV which in turn account for only 70 % cent of cervical cancer cases.
And so Cancer Research UK has recently launched a new campaign ‘Screening Matters’ to help support the Cancer Reform Strategy’s announcement that screening provision in the UK must be a priority.
The campaign aims to see at least three million more people screened for different cancers over the next five years. For cervical screening this has three main implications for the primary care sector:
1. Reach out to women who are eligible for screening but who aren’t taking part.
Estimates suggest that three million people in the UK are not registered with a GP and women who are not registered do not receive invitations for cervical screening. Worryingly the number of young women who attend screening is falling. Some women from black and minority ethnic groups and many women from deprived backgrounds also miss out on screening, often because they don’t realise that screening can save lives.
Cancer Research UK is funding research to understand more about the reasons for non-attendance so it can help to devise ways to increase uptake. The charity is also calling for relevant information to be targeted at those social and cultural groups where attendance is low so that more women can make informed choices.
Some studies show that many women are unaware of the risk factors associated with cervical cancer, indeed, many don’t realise that HPV is the major cause of cervical cancer. So Cancer Research UK would like to see public health messages keep pace with new developments, and clarify the facts about the new HPV vaccine – in particular that this won’t guarantee protection against cervical cancer, so all women should go for screens when invited.
‘Screening Matters’ urges all Primary Care Trusts to undertake an equality impact assessment, conducted by the UK National Screening Committee, in order to identify vulnerable groups with low screening uptake and to clarify ways to improve coverage.
2. Reduce the variation in screening across the UK.
It is vital to ensure that the best prevention strategies, and the most effective screening programmes, are implemented right across the UK. As an immediate measure Primary Care Trusts should complete the roll-out of liquid-based cytology (LBC), the new method of preparing cervical samples, in England by October 2008.
There are also pilots underway testing the effectiveness of introducing HPV tests for women with mild or borderline test results. Any benefits of these new initiatives and important public health messages should be introduced throughout the country.
3. Provide the best possible screening programmes through funding, staffing and measuring success.
The Government has agreed that by 2010 women should not have to wait any longer than two weeks for their cervical smear results. This can be done by recruiting more experts in cervical cytology and collecting data centrally to provide better information.
So while Cancer Research UK acknowledges the improvements and advancements that have been made since the introduction of the cervical screening programme, we need to remain vigilant on this issue because screening saves lives.
Dr Lesley Walker is Director of Cancer Information at Cancer Research UK