Cervical Screening

Alex Davies-Jones Excerpts

Monday 19th July 2021 Westminster Hall

[Alex Davies-Jones (Pontypridd) (Lab)]

It is a pleasure to serve under your chairship today, Mr Pritchard, and I am incredibly grateful to be called to speak in this debate on a topic that, as colleagues may know, is extremely close to my heart. It is also a pleasure to follow the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont).

Fiona’s story is tragically similar to so many other women’s stories across the country, and my thoughts and condolences are with the whole Mathewson family. As elected representatives, we have the great fortune of being able to speak up on a huge range of the issues that matter most to the people who live in our local communities. It is a fantastic privilege, and one that is not at all lost on me, but there are still certain debates that speak to us as people, not just as politicians. I will always be a vocal and loud champion of cervical screenings, and I am grateful that we are taking the time to speak about this important issue today.

We know that cervical screenings are the best way to protect against cervical cancer: the numbers speak for themselves. Indeed, cervical screenings can prevent more than seven in 10 diagnoses. Those who know me well will know that I speak about cervical screenings whenever and wherever I possibly can, mostly because a delayed cervical screening changed my life almost overnight. Like many others, I put off having my first cervical screening at the age of 25 for all the usual reasons: I was too busy, I did not have the symptoms, and I simply had other priorities. After many conversations with friends, most of whom gave me a good telling-off when I shamefully revealed that my screening had been delayed, I booked my appointment and thought nothing more of it.

While most of us will agree that cervical screening is probably not up there with our top 10 favourite things to do on a morning, the test itself is relatively quick and simple, but as many of us will know, the wait for the results—for that NHS letter arriving on our doorstep—can feel genuinely endless. In my opinion, it is the hardest part about being tested.

Fast forward to a few months after the screening, and I was sat in my local hospital undergoing a colposcopy after my initial test results came back abnormal and further examinations were required. I was genuinely terrified. Everyone had told me that a routine screening was nothing to be concerned about: that it would just be five minutes of awkward conversation with the nurse at my local GP practice, and it would be job done for the next three years in Wales. Sadly, that was not the case for me. I was told that I had abnormal CIN 3 cells that, if left undetected and untreated over a number of years, could develop into cervical cancer. We always think it will not happen to us, but there I was at the age of 25, diagnosed with CIN 3 on a large area of my cervix.

The next few weeks were a complete blur. I became obsessed with googling everything I could about abnormal cells, potential treatment and cervical cancer. I became a prolific poster on, and reader of, the excellent Jo’s Cervical Cancer Trust forum, and I found comfort in talking to others who had gone through, or were going through, exactly the same thing. Thankfully, the staff at my local hospital were incredible, and almost immediately I underwent LLETZ—large loop excision of the transformation zone—treatment to burn off the abnormal cells on my cervix. I went to that appointment alone. It was one of the most surreal moments of my life and one that, try as I might, I will never forget. After the doctor had finished—which felt like an eternity at the time—she did not look happy. More treatment was needed. She told me that on closer inspection, the abnormal cells on my cervix were embedded deeper and looked more challenging than initially expected. I will never forget those words.

The next stage for me was a cold knife biopsy. Thankfully that minor operation went smoothly, and a few weeks later I got the call that I had desperately hoped for: the clinicians were confident that all the abnormal cells had been removed. The damage was quite severe, and if I had put off that initial cervical screening test any later, the situation would have been very different. The extent of the treatment meant that I was now without the majority of my cervix. Of course, having that treatment comes with risks, such as a slightly increased chance of giving birth prematurely, but by that point I did not really care: I just wanted the nightmare to be over.

I was without the majority of my cervix, but my life was saved. Sadly, for many—as we have heard, tragically, in Fiona’s case—that is not the case, and I count my lucky stars that my friends gave me the push I needed to book my cervical screening when they did. After receiving treatment, I attended screenings every six months to ensure the abnormal cells did not return. Even now, years down the line, my screenings are more common than most, and I go on an annual basis.

It would be wrong of me to pretend that I have not been impacted on by the ordeal I went through. The physical scars might be internal, but I will always grapple with the mental effects. Even years on, I still get that nervous feeling in my stomach before I go to my screening. However, we have all seen the numbers—my hon. Friend the Member for Gower (Tonia Antoniazzi) touched on them in her opening remarks—and we can all recognise the devastation that cancer, in its myriad forms, can have on those suffering and on their close friends and family. It goes without saying that we should be doing everything we can to protect those who may be particularly at risk of developing cervical cancer, and regular cervical screenings are absolutely key if more lives are to be saved.

Although I am pleased to say that there has been progress on specific incentives to encourage more people to attend their screenings, cell changes such as mine often fall through the gaps, along with HPV. HPV diagnosis is still associated with high levels of fear, confusion and stigma and a lack of understanding, despite it being an incredibly common virus. Jo’s Cervical Cancer Trust recently surveyed its community of users who have HPV and found that one in two people said they knew nothing about HPV prior to receiving a diagnosis. Interestingly, people with recurrent or persistent HPV report feeling let down by their bodies and anxious about the ongoing and uncertain nature of the condition, and they often feel that there is no support or information for them either. There is clearly a need for increased education when the vaccine is first given, greater awareness of how common it is and how it affects the body, and greater information and support for those affected.

The same goes for cell changes such as mine. Around 220,000 women each year will be told that they have cell changes, and many will be treated to prevent the potential development of cervical cancer. There are opportunities to improve the care that is offered. We know that treatment for cell changes is highly effective at preventing the development of cervical cancer, the impact of which can be truly devastating, but more must be done to ensure that women diagnosed with cell changes are properly supported before, during and after treatment. Research from Jo’s Cervical Cancer Trust found that 20% of women said the possible impacts and side-effects of treatment were not explained to them beforehand. Even more shockingly, 60% were not told about the different types of treatment that were available to them. It is clear that although progress has thankfully been made on the dialogue around cervical screenings, we still have a long way to go to change the situation more broadly.

I am hopeful that today’s debate will send a reminder to those who, like me, put off their cervical screenings. I also hope that by touching on issues such as HPV and cell changes, people can learn about the broader benefits of screening too. Although health is of course devolved to the fantastic Welsh Labour Government, I truly believe that this is an issue that crosses the political divide. Indeed, I look forward to hearing from the Minister about the work that she is doing, including across Government Departments and the devolved nations, to encourage better understanding of the widespread benefits of cervical screening.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Mr Pritchard.

First, as I think everybody else has done, I thank those who initiated this petition in Fiona Mathewson’s memory, and I join others in extending my sympathy to Andrew, to Ivy, to Harry, to Caitlin and to Fiona’s broader family, as well as to the 3,000 individuals in Kelso and across the borders who signed the petition.

Like other hon. Members, for example, the hon. Member for Pontypridd (Alex Davies-Jones), I know how frightening it is to be given this kind of diagnosis, but I can only imagine the impact on Andrew and the loss that he feels. However, if I may say one thing, it is that this debate today is in itself a huge legacy for Fiona, because we are discussing sensibly what we need to do to help women. We are talking, as many people have said, about something that is often seen as a little bit embarrassing. In response to the points by hon. Members that we must improve take-up, I could not agree more. However, we will not achieve that by not talking about some of the challenges that exist.

Cancer screening is crucial and I thank each and every Member who has shown their support for it and contributed to today’s debate. It was eloquently introduced by the hon. Member for Gower (Tonia Antoniazzi), as the Petitions Committee allowed us to have this conversation across the United Kingdom. The simple fact is that screening saves lives and that is why we need to drive uptake. As we have heard, screening can prevent cancer from developing. It can catch cancer earlier and, as we know, the earlier people are diagnosed the better the outcomes, because there is a greater chance that treatment can be successful.

Thanks to the tremendous work of dedicated screening staff up and down the country, the NHS cervical screening programme reaches about 4.6 million women in England every year and currently saves about 5,000 lives. However, we have heard repeatedly that only about 70% of women actually take up the opportunity, for a plethora of reasons. If everybody did attend, that number of lives saved would be closer to 7,000. More lives would be saved, so when a woman receives an invitation to attend a screening appointment, I encourage her to go.

As the hon. Member for Central Ayrshire (Dr Whitford) said, if you notice anything amiss, such as bleeding after sexual intercourse, between periods or during menopause, discuss it with a medical professional. Do not wait—it is your body and just treasure it. I say that because screening is one tool, but that knowledge of yourself is another tool that you have to access treatment quickly. NHS services are open, safe and ready to help you. That is another thing that has come through: I want to reinforce the fact that the NHS is open and the services are safe. You must come forward when your invitation for an appointment.

[Alex Davies-Jones]

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) talked about some of the challenges faced by the lesbian and bisexual community in accessing appointments, but we also need to recognise some of the challenges faced by our trans community, especially trans men, in accessing appointments. Many of them are not sent reminder letters because of administrative policies at GP services. Will the Minister look into that to ensure that everyone with a cervix who is eligible to attend a screening receives a reminder?

[Jo Churchill]

Indeed I will. I would be happy to write to the hon. Lady, because I have looked at that issue. If there is a chance that someone may have abnormal cells, they should get them checked out. The hon. Member for Coventry North West (Taiwo Owatemi) spoke about making sure that we reach those communities who would not necessarily come forward, for a number of reasons.

The hon. Member for Wythenshawe and Sale East (Mike Kane) spoke, as several did, about using technology better, and about the challenges of screening and the health inequality that there is in certain communities for access to screening. I have met NHS England several times about that, to think how we can use that technology and different avenues—I will speak in a minute about the self-sampling sample.

We have to think differently about how we encourage women, because not every woman will come forward in the same way. We have different pressures on our lives at different times. Perhaps we are not as good at the younger end, because people think, as the hon. Member for Pontypridd said so eloquently, “I didn’t think it would happen to me.” Perhaps they have a young family or are busy at work. All those things mean that we have to make it as easy as we possibly can to access screening wherever you are and in whatever form suits you, because there are also cultural barriers for some not only to cervical screening but to breast screening, where they are hesitant to come forward.