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Could lack of access to GPs be putting women off booking cervical screenings?

No one looks forward to cervical screening. If even the word ‘speculum’ strikes fear into you, you’re not alone. But a smear test can be life-saving, so why are so many women still not coming forward? 

I had the letter last week. You know the one: it’s been three years since my last cervical screen. Even though I’ve always religiously attended my screenings, it’s not something I look forward to, and studies show that almost one in three women don’t take up the offer to get screened. All women and people with a cervix between the ages of 25 and 64 are invited to attend a cervical screening (previously known as a smear test) every three years. So why are so many of us skipping it and endangering our health in the process? 

What is cervical screening?

A cervical screen is essentially a way of checking your cervix (the neck of the womb) for cervical cancer warning signs and symptoms. The procedure is usually performed by a doctor or nurse in your GP surgery and involves taking a swab of cells from the cervix, which is sent for analysis. Usually you will have the results in a couple of weeks, and it’s a relatively quick and mostly painless experience.

“Cervical screening helps prevent cervical cancer by checking for a virus called high-risk HPV,” explains Dr Zoe Watson, GP and founder of wellbeing platform Wellgood Wellbeing. “If this virus is found in the cells of the cervix, the cell samples will then be checked for evidence of cervical cell changes. It’s not a screen for cancer itself, but rather a screen to check for evidence of pre-cancerous cells and risk factors for cervical cancer (HPV).”

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According to Cancer Research UK, 99.8% of cervical cancer cases are preventable, and with around 3,000 new cases diagnosed each year, it’s vital that we’re all keeping up with our screening.

“Cervical screening is important because it can be genuinely lifesaving if pre-cancerous cells are detected,” advises Dr Watson, “as these pre-cancerous cells are then treated, thus preventing a cervical cancer from developing. Along with the HPV vaccine, cervical screening is the best way to protect against cervical cancer and prevents over seven in 10 diagnoses.”

Why aren’t women attending their cervical screening appointments?

According to the charity Jo’s Cervical Cancer Trust, half of all cervical cancers occur in women who have never been screened or are not up to date with screening, and the reasons for non-attendance are largely personal.

“I think the answer to why people aren’t attending screening is probably different for everyone,” says Dr Watson. “Humans are complex creatures, so I think to encourage screening, we have to be mindful and understanding of all of the reasons for not wanting to go, and accommodate them as far as possible.”

We’re worried it’s going to hurt

Let’s be clear – a cervical screen is not going to be a pleasant process. But any discomfort is short-lived, and I’ve found that some deep breathing can really help you to relax, which makes the screening way easier.

“Some people may not want to come as they find the test uncomfortable and invasive,” agrees Dr Watson. “And some people make have experienced traumatic events surrounding sexual assault or abuse. So for them, having an invasive test like a smear can trigger symptoms of PTSD.”

If you’re struggling with any of these issues, it’s important to speak to your GP, as they might be able to suggest ways to make the process less stressful for you. And remember to ask for a smaller speculum if it’s really uncomfortable – they come in different sizes. 

It feels embarrassing

There’s no denying that stripping off in front of a total stranger can be intimidating. But bear in mind that the test will be carried out by a trained health professional, and if you feel more comfortable having a chaperone in the room with you, that’s fine too.

Long waiting times

Charities are warning that long waiting times are putting women off even making the appointment in the first place.

“Some people are struggling to get an appointment and they’re being put off by long wait times,” acknowledges Dr Watson. “But if GP access is the barrier, then it’s worth exploring other options. Some sexual health clinics offer screenings (but not all), so it’s worth checking if you’re due for a test and can’t get an appointment with your GP.”

We’re too busy to attend an appointment

“About 10 years ago, in the aftermath of Jade Goody dying from cervical cancer, I tried to get an appointment for a cervical screen,” recalls personal trainer Eliza Flynn. “But because I was three months too early, I had to wait. I ended up not booking an appointment until about three months or so past the time I was allowed because I was so busy, and when I did go, they discovered I had CIN 3, a precursor to cervical cancer.”

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We’re scared

“I was really upset and frightened when I found out my results were abnormal,” recalls Flynn. “It felt like I’d been failed by my doctor. All sorts of things go through your mind when you’re told that your results are abnormal and you’ll need an operation. I was planning on what I’d do if I only had a certain amount of time left. It was such a relief to know that they’d been able to remove all the abnormal cells.”

Of course, it’s scary to think we might be at risk of developing cancer. But burying our heads in the sand isn’t going to change that fact – and knowing the facts early could quite literally save lives.

We ignore the invite

Luckily, Flynn’s operation was successful, and all her pre-cancerous cells were removed, but stories like this have an impact – especially on younger women, who may never have had a test. Business owner Elizabeth Rees didn’t attend a cervical screening until she was 29.

“I didn’t go for my first smear until after I had my first child at 29 years old. I knew I could have accessed appointments from when I was 21, and luckily I was OK. But knowing what I know now, I feel so frustrated that women aren’t getting screened and it’s the driving force for me shouting about this topic as much as I can,” she tells Stylist.

Alongside her teaching job, Rees now designs bags and accessories “to break the taboo and start more conversations about the five gynaecological cancers and encourage those invited to attend their cervical screening”.

All of which reminds me that my own invite is stuck to my fridge, and I keep meaning to make the appointment every time I reach for some milk. BRB, I’m off to make a phone call.

Images: Getty

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  • Posted on February 1, 2023