What’s new in the cervical screening service?

The Eve Appeal's Information Nurse, Tracie Miles, explores the recent changes to the cervical cancer screening invitation letter, and the potential impact this may have on women when deciding to attend their next smear.

The invitation letter women receive as a reminder to attend their cervical screening from NHS England has recently changed. It now includes a sentence stating ‘it is up to you whether or not to have cervical screening’. This may seem surprising but the fact is, every woman has always had a choice about whether or not to attend cervical screening.

Recent cervical screening invitation letter from NHS England

In 2014/15, there was an increase in non–attendees to cervical screening, with only 3.1 million women being tested, despite approximately 4.3 million women aged 25 to 64 being invited to undergo screening. This accounted for a fall of 3.3 per cent from the previous year, when 3.23 million attended a cervical screening appointment.

Screening protects women from cervical cancer and failure to attend can significantly increase the risk of developing this potentially preventable cancer. The evidence is clear, cervical screening saves lives. Screening and vaccination against the high risk human papilloma virus (HPV – the virus that causes cervical cancer), in eligible age groups are the two most powerful strategies to protect women from cancer. You should therefore make the right choice and attend for screening when invited.

There are other changes in the screening programme in an attempt to make it more accurate. For instance, the screening test used to be called a smear test, because the technique involved using a wooden spatula to collect cells shed from the cervix. These cells were ‘smeared’ onto a glass microscope slide. Now cells are collected using a gentle soft plastic brush, that are then transferred to a special liquid ready for testing.

The new screening system also has the advantage that the sample can be checked for infection with HPV. Everyone who has screening, is also tested for HPV simulataneously, this is helpful for the small minority of women who have mild abnormalities detected on their screening test. If the HPV test is negative, the woman is not at risk of developing cancer and can return to either three or five yearly screening cycles. If the test is positive, the woman is referred to hospital for additional tests to determine if she needs treatment to prevent the abnormal cells ultimately developing into cancer.

However, women aren’t routinely screened for HPV because the virus infection cannot be treated, the only option available is to treat the cell changes it causes. In addition, in the vast majority of women, the HPV infection is harmless and cleared up by the immune system after a very short period.

So back to the beginning of our blog, concerning the new invitation letter from NHS England and the recent changes which have been made.

It states ‘it’s up to you whether or not to have cervical screening’ and at The Eve Appeal we worry this may be interpreted as asking you to take a risk, a chance with your health. It suggests that you might consider opting out of what we know is the most effective woman’s health screening programme.

In making the decision about whether or not to attend, you should carefully consider all the information in the accompanying leaflet. This will ensure that you’re making an informed decision based on your own personal situation – however in our minds, there is simply no doubt about it, we would implore all women who are invited to attend their cervical screening appointments!

If you’d like more information on cervical cancer and the screening programme, please contact our free, confidential gynae-cancer information service, Ask Eve on 0808 802 0019 or get in touch via email nurse@eveappeal.org.uk