When the letter arrives informing me that I am due a smear test, as it does every three years for women aged 25 to 49, I do what many women do: I recycle it. There will be a reminder. Or I hide it under a pile of papers to find in a couple of months’ time.
I know I am not alone in this, because the latest figures from NHS Digital show that the number of smear tests being carried out in England has reached a 20-year low. The overall decline may seem small – in March 2017, the percentage of women deemed to have been screened adequately fell to 72% from 72.7% the year before – but the figures mask a persistent decline in women booking tests.
After the reality TV star Jade Goody lived out her final months in front of the cameras before dying of cervical cancer in 2009, aged 27, nearly half a million more women than usual turned up for a smear test. But now the Jade Goody effect has “been forgotten about”, says Kathryn Hillaby, a consultant gynaecologist at Gloucestershire hospitals NHS foundation trust.
Thomas Ind, a consultant gynaecological surgeon at the Royal Marsden in London, thinks the HPV jab has bred complacency. Hillaby sees “a message and outreach problem”.
Cervical screening can detect abnormal cells before they turn cancerous. It is one of very few preventive cancer tests. According to the charity Jo’s Cervical Cancer Trust, which is readying itself for Cervical Cancer Prevention Week this week, early detection and treatment through cervical screening in the UK can prevent up to 75% of cervical cancers from developing. Why, then, are women so resistant?
Claire Cohen is head of health information and engagement at Jo’s. A roadshow last year under the banner “Be cervix savvy!” helped her to identify health literacy, failure to understand the risk, accessibility of clinics and fear of findings, pain and embarrassment as factors. Ind, who treated Goody, hopes another celebrity will come forward. “I have had similarly [high-profile] patients with abnormal smears. We just need an ambassador,” he says.
Hillaby wants to reassure people. “I have just finished a clinic,” she says. “The women have a sheet over them at all times. They have somewhere private to change. It’s a few seconds for something that could change your life.”