Today Dr Eleanor Draeger, a Sex Education Trainer and Sexual Health Doctor, discusses the importance of teaching children about cervical cancer prevention
We teach children about prevention all the time. We teach them to clean their teeth, to prevent tooth decay, and to wear a coat in winter, to prevent them feeling cold. We also teach them to use condoms, to prevent STIs, and to use contraception, to prevent unplanned pregnancies. So it stands to reason therefore that we should also teach them how to prevent cervical cancer.
Cervical cancer is caused by the Human Papilloma virus (HPV), which is a sexually transmitted infection. You might think, therefore, that you could prevent it just by using a condom, but it’s not as simple as that, because it is transmitted by skin-to-skin contact, and because there are no visible signs of initial infection. We do, however, have two main other ways in which cervical cancer can be prevented – the national cervical screening programme, and HPV vaccination. The best way to ensure that uptake of both these programmes is as high as possible is to teach children about them and how important they are before they need to take part.
The government agrees with this stance, and in the new Draft Guidance for Relationships Education, Relationships and Sex Education (RSE) and Health Education it states:
“Pupils should know… the benefits of regular self-examination (including screening and immunisation)”
The cervical screening programme was introduced in the UK in the 1980s, and since then the number of cervical cancer cases has gone down by 7% each year (source: NHS). The screening programme looks for the early signs of change in the cervix that happen after someone has been infected with HPV. These changes can then be treated, to prevent cancer developing. HPV vaccination was introduced into the NHS vaccination schedule in 2008, for girls aged 12-13, and it will soon be extended to include boys as well.
We are fortunate to now have vaccinations against two types of cancer – hepatocellular carcinoma (which is caused by Hepatitis B) and cervical cancer (which is caused by HPV). According to the World Health Organisation, vaccination against HPV and Hepatitis B could prevent 1 million cancer cases each year. This is a target that we should be supporting, by ensuring that we encourage as many people as possible to take part in the nationwide prevention programmes.
Yet, despite the fact that cervical cancer is eminently preventable, smear test rates are the lowest they have been in two decades, with 1 in 3 women aged 25-64 not having a smear within the right time frame for their age. Jo’s Cervical Cancer Trust recently surveyed 2000 women about their experience and found that 915 of them had either delayed a test or never had screening. The number one reason for this was embarrassment, with fear of vulnerability coming a close second.
This really resonates with me, as I remember the friend I helped a few years ago. She confessed to me that she had never had a smear test, although she had met the criteria for screening for several years, because she was too embarrassed to go. After some discussion we came up with a plan – I went with her to the clinic and waited outside the room while she went in. We also spent some time beforehand talking about exactly what the procedure involved. Of course, most people will not have a doctor that they can take with them for their smear test, but they will all have a friend. And any clinician should be happy to do a smear test for a patient who has a friend with them for moral support.
Young people need to be empowered to look after their own health, including their own sexual health, and with a comprehensive programme of relationships, sex and health education at school we can give them the information they need to do so. Condom demonstrations and the like may seem embarrassing and difficult for teachers to teach their students – but they could be genuinely life-saving.