Cervical screening: Millions missing smear tests

About three million women across England have not had a smear test for at least three-and-a-half years.

GPs are trying to improve take-up rates as figures show up to half of women under 50 in some areas have not had a cervical screening in the recommended time frame.

Screening rates are apparently at their lowest for two decades and Public Health England said it was “concerned” by the fall.

A further million women aged 50 to 64 have not had a smear test for at least five and a half years.

About 72 per cent of women aged 25 to 64 have had a smear test within the period recommended for their age, according to figures compiled in March 2017.  This figure is down from 75.4 per cent in 2012.

A total of 220,000 British women are diagnosed with cervical abnormalities each year and there were 854 deaths from cervical cancer in England in 2016.

Cervical screening detects abnormal cells on the entrance to the womb.

The NHS target is for 80 per cent of women aged 25 to 49 to be tested every three years.

London has some of the lowest rates of women screened for cervical cancer. In some boroughs just over half of eligible women under 50 had a test within the past three and a half years.


Why have so many women not received a screening?

Experts put it down to embarrassment, a lack of awareness or just putting it off.

A survey of 2,017 women by the charity Jo’s Cervical Cancer Trust suggested young women were embarrassed to attend smear tests because of their body shape (35 per cent), the appearance of their vulva (34 per cent) and concerns over smell (38 per cent).


Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare, said:

Cervical screening is not a mandated requirement for local authority commissioning. Local authorities under severe budgetary pressure are not including this essential aspect of women’s health care in their service expectations.

GPs have a very positive role to play in increasing uptake by offering opportunistic screening, but primary care is not able to effectively meet the increased demand.

Screening rates are now at their lowest in two decades and the minimum 80 per cent national target is far from being achieved, she added.


Professor Anne Mackie, Public Health England’s Director of Screening said:

PHE, alongside charities including Jo’s Cervical Cancer Trust, the NHS and local authorities, are concerned about the fall in women taking the test.

Currently, only 72 per cent of women have cervical screening and we’re working together to ensure that every woman knows what the test is about and to make it easy to attend screening appointments.


Two major components to early cancer detection are symptom education and pre-symptom screening. Detecting the disease whilst it remains localized improves the success of treatment and it’s important that women are encouraged to get screened for their own peace of mind. It’s not a pleasant experience and that can understandably be off-putting, but it’s important to attend cervical screenings every three years for those aged 25-49.

We offer services at Cignpost that can potentially lead to an earlier diagnosis and better health outcomes for anyone who feels that they may have a serious health issue. We are lucky enough to have a partnership with the Sarah Cannon Research Institute (SCRI). They provide further treatment pathways and offer clinical trials via a number of different routes on a case by case basis.

17% of cancer patients in the UK now take part in trials, which sees innovative new treatments being tested to help find out which treatments work, how best to use them and what the potential side effects are.

At Cignpost we have multiple case studies where the SCRI has helped to find alternative treatment paths for individuals, which have led to better health outcomes. We’re always looking at new ways to help our members and to offer alternative routes to treatment. Growing relationships with partners like the Sarah Cannon Research Institute allows us to do that and stay on top of the most cutting edge treatment pathways.



Text references

BBC News. (2018). Cervical screening: Millions missing smear tests. Accessible: https://www.bbc.co.uk/news/uk-england-45593583. Last Accessed: 23 October 2018.

Sarah Cannon Research Institute. (2018). The First Step. Accessible: http://sarahcannonresearch.co.uk/for-patients/the-first-step/. Last Accessed: 24 October 2018.