Should the NHS re-think cervical cancer screening?

Public Health Wales (PHW) announced that they are increasing the gap between smear tests for cervical cancer from three to five years; the increase was introduced in Scotland in 2020. The change was met with outrage in Wales and there is fear of the change being introduced in England. 

PHW justified this decision in 2018, stating: “The test is more effective at identifying people at higher risk of developing cell changes which can cause cervical cancer… Evidence shows that it is safe to extend the time between cervical screening (smear) tests for people who do not have HPV.”

How do we test for cervical cancer?

A smear test involves inserting a swab through the vaginal canal to the cervix to take a sample of cells from the area. The swab is sent to a lab to check if any cells are abnormal. Here is a video showing the process:

How cervical screening is done | NHS

The recommended age to book your first smear test is 25. While the thought of a smear test may be daunting due to its invasive nature, it is extremely important to book these tests. 

Dr Julie Sharp, head of Health Information at Cancer Research UK says: “Whatever your age and whether or not you’ve had a smear test, it’s important to go to your GP if you notice anything out of the ordinary.” This could be bleeding between periods or after sex, or pain during sex. The chances are that it may not be cancer, especially in women under 25, but it is always a good idea to get it checked out by a doctor.

What is Human Papillomavirus?

Human Papillomavirus (HPV) is a virus that is transmitted via skin-to-skin contact and mostly effects the mouth, throat, and genital areas. HPV can cause genital warts and cancer which can be prevented with the HPV vaccine. It is currently offered to all students aged 12-13. When I received my vaccine in 2013 aged 14, it was only offered to girls as a way of preventing cervical cancer. 

While cervical cancer is the most common cancer caused by HPV, there is a lack of discussion around men’s health in our schools. I was taught how to check for lumps in my breasts and received the vaccine again. Since they were not part of the conversation, boys were under the impression that HPV and breast cancer would never affect them. This is not true, as HPV can cause anal and penile cancer in men. I am glad to see acknowledgement that all genders benefit from basic health and sex education.

How successful has the cervical cancer screening programme been?

According to research conducted by Cancer Research UK, approximately 1,900 cases are diagnosed each year in women aged 25-64 in England. Since the introduction of the cervical screening programme, cases dropped by over 40 per cent between 1988 and 2010.

Cervical cancer is a common form of cancer in women under the age of 35 in the UK, highlighting the importance of attending screenings regularly. We are a generation where talking about women’s health is no longer an improper subject for public discussion. However, there is still a lack of open discussion in schools around the subject.

When I left school, I had a severe lack of knowledge about my uterus and vaginal health. I had to search where the cervix even was within the uterus. I learned more about a women’s uterus from a book I recently read called Vagina A Re-education by Lynn Enright then anything I learned in 5 years of sex education and biology lessons. This book also covered deeper taboo topics such as abortion, miscarriage and infertility. This lack of knowledge  means that women are not fully informed about the importance of cervical cancer screening.

The main risk of cervical screening is not actually the test itself, but of the removal of abnormal cells if found, known as a colposcopy. A specialist takes a small tissue sample (biopsy) to further check areas. The removal of more cells could lead to abnormal bleeding or infection, as well as affecting future pregnancies. These women are at higher risk of going into premature labour. 

If women are concerned about their cervical health, allowing women under the age of 25 to ask for a screening should be permitted. I personally would attend one now at 23; I feel ready, and I want to be more informed about my body. Most women my age who I speak to still dread theirs and want to wait until they are 25 so I do not believe that there would be a large influx in women going forward for testing if it only optional for under 25s.

I do not believe it is necessary to increase the gap between smear tests. I would love to have children one day and I would like to be as informed as possible on the condition of my uterus and cervix. I acknowledge the risks of a smear test, but I would feel comforted by having the option of a spot check if I felt something was wrong with my body. We are told to trust the professionals, and I do; however, gut instinct is a powerful thing when it comes to individual health. To make it easier for women to understand the risks and the benefits of cervical screening, the government should focus on improving sex education so we become young adults who are fully informed and can comprehend health decisions like these better.

Feature Image: Unsplash

Sophie is a first-year student studying BA Media, Society and Culture from Birmingham. Her biggest areas of interest in media and journalism are breaking down stigmas surrounding feminism, mental health issues and sex positivity. She also enjoys writing and painting. Find her on Instagram: @soph_mouzakitis and on her blog, The Periodical.

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