I very much welcome the news from NHS Information that there has been an increased uptake in cervical cancer screening in England and entirely agree with Robert Music from Jo’s Trust that this is likely to be as a direct consequence of the media coverage of the Jade Goody Story. The increase in screening uptake was reflected by an increase in colposcopy referrals, up by up to 60% earlier this year in some NHS trusts. Patients who have neglected their screening invitation for several years tell me that they attended this year because of Jade Goody.
Cervical cancer is potentially preventable and screening offers significant protection. Figures from the NHSCSP indicate that if an overall coverage of 80% is achieved (i.e 8 in 10 of women from the 25-64 age group take up screening), this can lead to a 95% reduction in deaths from cervical cancer in the long term.
It is rather disappointing therefore that screening uptake has fallen year on year from 1999 to 2008. In 1999, coverage was well above 80% but 2008 was the third consecutive year in which coverage fell to under 80%. In March 2008, coverage was 78.6%. There is a geographical variation, with some areas in London reporting coverage of under 60%. Uptake of screening is lowest in the 25-29 age group and was still under 65% in 2009, despite an overall increase in coverage. This is of concern as this is the group with the highest proportion of abnormal smears. The reasons are multi-factorial but essentially indicate low awareness amongst the less well informed, less well educated and more difficult to reach groups.
So while the increased uptake this year is a welcome trend, it is important that health care providers are not complacent. The press has typically been reluctant to cover cervical cancer as the disease unfortunately remains stigmatised. Jade Goody is no longer in the headlines and attention has turned to other events. The challenge therefore is to implement strategies to maintain ensure that coverage remains above 80%, particularly in the most vulnerable groups.
Adeola Olaitan has summarised the latest factual information on screening, prevention and treatment of cervical cancer in her series of ‘plain English’ articles on in Capital Health.