Welcome to the latest edition of PHE’s Health Matters, a resource for local authorities and health professionals, which for this edition focuses on the decline in cervical screening attendance in England and outlines what can be done to boost screening coverage.
Although cervical cancer mortality rates have decreased by up to 70 per cent since the introduction of the NHS Cervical Screening Programme in 1988, there were still 726 deaths from the disease in England in 2014 and a total of 890 in the whole of the UK.
Worryingly, screening coverage has fallen over the last 10 years and attendance is now at a 19-year low. Coverage is going down across all age groups.
Screening figures collected by NHS Digital show that coverage amongst women aged 25 to 49 years was 70.2% at 31 March 2016. This compares to 71.2% as at 31 March 2015 and 73.7% as at 31 March 2011.
For women aged 50 to 64 years, the coverage at 31 March 2016 was 78.0% which compares to 78.4% as at 31 March 2015 and 80.1% as at 31 March 2011.
At a regional level, coverage of the full eligible age group in 2016 ranged from 66.7% in London to 75.9% in the East Midlands. The vast majority of reporting regions reported a fall in coverage at 31 March 2016 when compared with 2015.
51 out of 160 local authorities achieved coverage of 75% and above. 58 local authorities achieved coverage of 70% to less than 75%. The national target for cervical screening coverage is 80%.
Women are offered screening every 3 or 5 years depending on their age. Women aged 25 to 49 are invited for routine screening every 3 years, whereas those aged 50 to 64 are invited for routine screening every 5 years.
Cervical screening is not a test for cervical cancer. Screening is intended to detect abnormalities within the cervix that could, if undetected and untreated, develop into cervical cancer.
It is estimated by UK researchers that in England cervical screening currently prevents 70% of cervical cancer deaths. However, if everyone attended screening regularly, 83% could be prevented.
However, a number of barriers exist that are hindering women from attending. The most common reasons for not attending screening are embarrassment about having a smear test and worry about the outcome of the test.
Several studies have identified groups that are frequent non-attenders for screening which includes women over 50, younger eligible women, women from ethnic minority groups, as well as lesbian and bisexual women.
What can you do?
This edition of Health Matters outlines how local authorities, Clinical Commissioning Groups (CCGs), and GPs can all play a key role in raising awareness of cervical screening and encouraging women to attend screening.
Although screening is most commonly delivered in primary care, local authorities have a crucial role to play in raising awareness of cervical screening. Local authorities can work directly with GP surgeries to raise awareness of screening as well as through outreach work with women in their communities.
GPs and practice nurses can play a central role in educating women and therefore in increasing attendance for screening.
All women must be given the opportunity to make an informed choice about whether or not to attend for cervical screening. The decision should be based on an understanding of:
- why they are being offered screening
- what happens during the test
- the benefits and risks of screening
- the potential outcomes (including types of result, further tests and treatment)
- what happens to their screening records
Read more about ways to make cervical screening more accessible in this edition of Health Matters which includes a set of infographics and slides to support local commissioning and service delivery, as well as best practice case studies.
Visit the Health Matters area of GOV.UK to see the wide range of topics Health Matters has covered (other recent editions have looked at child dental health and obesity/food environment) or sign up to receive the latest updates through our e-bulletin.
And if you found this blog helpful, please view other Health Matters blogs.
Health Matters is a resource for professionals which brings together the latest data and evidence, makes the case for effective public health interventions and highlights tools and resources that can facilitate local or national action. Visit the Health Matters area of GOV.UK or sign up to receive the latest updates through our e-bulletin. If you found this blog helpful, please view other Health Matters blogs.