Government ‘must commit to eliminating cervical cancer in the UK’

The Government must commit to eliminating cervical cancer in the UK through improvements to screening, public awareness and vaccine uptake, a charity has said.

Around 3,200 women are diagnosed with cervical cancer and more than 800 die from the disease each year in the UK.

The World Health Organisation (WHO) defines the elimination of cervical cancer as four or fewer cases detected per 100,000 women in any year.

Now, Jo’s Cervical Cancer Trust is calling for increased action to eradicate the disease, saying “the UK has the tools to get there”.

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In a report, the charity says barriers to success include a lack of understanding around the effectiveness of the current vaccination programme, anti-vaccine sentiment, inequalities in uptake of cervical screening, competing NHS priorities and workforce shortages affecting how the programme works.

The UK currently offers a human papillomavirus (HPV) vaccine in schools together with a cervical screening programme and colposcopy services that help catch pre-cancerous cell changes.

However, the charity said some women still struggle to access screening, citing falling screening rates.

Almost one in three women across the UK are not up to date with their cervical screening, “with screening coverage at its lowest level in 20 years”, the report said.

The HPV vaccine has been routinely offered in schools to girls aged 12 to 13 since 2008 and to boys the same age since September 2019.

Around 13 high-risk types of HPV cause 99.7% of cervical cancers.

As a result of vaccination, cervical cancer has been almost eliminated in women born since September 1995, the Jo’s Trust report said.

However, England data for the 2021/22 school year shows HPV vaccine uptake in girls and boys fell by 7% and 8.6% respectively from the previous year.

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Coverage in England for girls receiving two doses by school year nine was just 67.3% – 20% lower than before the pandemic.

Meanwhile, in Wales, coverage of two doses of HPV vaccine in girls in the 2021/22 school year 10 was just 55.1%.

For its report, Jo’s Trust surveyed 848 people working in the field, including nurses, clinical nurse specialists, biomedical scientists, radiographers and cancer specialists.

Most of those polled said offering women, including those who do not turn up for screening, the opportunity to take an HPV test at home is “one of the biggest opportunities to eliminate cervical cancer in the UK”.

The report said the clinical accuracy of HPV self-sampling is high, but it may be less likely to pick up pre-cancerous changes to cells.

It said: “HPV self-sampling could provide a step change for many who find the existing test inaccessible.

“Policy decisions must balance any risks against benefits, while research must continue to remove any risks, continue to identify further ways to tackle barriers to screening and make the test as accessible as possible for everyone.”

Other recommendations from those surveyed include more education about the HPV vaccine in schools and national awareness campaigns about HPV and cervical cancer.

The report also recommended swift action regarding the recruitment and retention of staff working in the field, including in labs.

Samantha Dixon, chief executive at Jo’s Cervical Cancer Trust, said: “A world without cervical cancer doesn’t have to be a pipe dream.

“The UK has the tools to make it a reality, which is incredibly exciting.

“We need Government action to get there as soon as possible but everyone can play their part.

“Going for cervical screening when invited and making sure your child is vaccinated against HPV will help make cervical cancer a thing of the past.”

Dr Ellie Cannon, NHS GP and broadcaster, said: “Ending cervical cancer should be a priority and something we can all get behind.

“Progress to date has been too slow – GPs like myself are still seeing too many people miss their screening when called, which means they are in danger of being diagnosed late. This needs to change.”

The NHS urged anyone eligible for cervical screening to come forward.

Dr Kiren Collison, interim director for primary care at NHS England, said: “We have made great progress on our Cervical Screening Programme and the combined effects of the HPV vaccine and the new, more sensitive way of screening for cervical cancer means that we have the opportunity to eliminate cervical cancer altogether.

“Having the potential to completely eradicate a disease that affects thousands of people every year is remarkable, but in order to do this, it is vital that people take up the offer of a test – so if you have received an invitation, or missed your last screening, don’t wait to make an appointment, put your health first and book an appointment with your GP practice or sexual health clinic today – getting checked can save your life.”

Professor Peter Johnson, the organisation’s national clinical director for cancer, added: “Screening is an effective way to prevent cervical cancer developing or to catch it at a very early stage, which is why it is especially important that people attend their screening appointments.

“There are lots of reasons why somebody might not want to come forward – embarrassment, inconvenience, or uncertainty – but please speak to a healthcare professional if you are unsure.

“It’s also important to understand that HPV can remain undetected for many years before later going on to cause abnormal cells which can lead to cancer, so even if you’ve previously had a negative test, it is vital that you attend your next one.”

Meanwhile, the UK Health Security Agency (UKHSA) said that more needs to be done to ensure people eligible for their HPV jab come forward.

Dr Vanessa Saliba, UKHSA consultant epidemiologist, said: “The HPV vaccine is available for girls and boys in year 8 and we encourage everyone eligible to take up this potentially life-saving vaccine when offered. In recent years we have seen vaccine coverage fall due to the challenges posed by the Covid pandemic.

“Many young people who missed out on their vaccinations have already been caught up, but more needs to be done to ensure all those eligible are vaccinated.

“Children and young people who have missed out on their HPV vaccinations should contact their school nurse, school immunisation team or GP surgery to arrange a catch-up – they remain eligible until their 25th birthday.”