Cervical Cancer Smear Tests

Debate between Helen Jones and Anna McMorrin

Monday 28th January 2019 Westminster Hall

[Helen Jones]

My hon. Friend makes a very good point and I will be asking the Minister to look at that. Our first problem is getting people through the door. If there is something wrong with us, it is natural to think either that it will somehow go away or that it might be cancer—we kid ourselves that, if we do not get a diagnosis, it is somehow not happening. We need to have much more publicity to encourage young women to report to their GP if they have abnormal symptoms. After all, it might not be cancer and they might be reassured. Equally, if it is cancer, the sooner someone gets treated, the better their chances of survival. I do not think that that message is always getting through, particularly to younger women.

The other problem is that the rates of people attending screening, even among those who are eligible, are falling. In the last year for which I have figures, only 69.1% of eligible women attended their screening appointments. That is down from 73.7% in 2011. In practice, that means that 3.5 million women in this country have not been screened in the past three and a half years. That is very worrying. Even more worrying is the fact that 1.7 million have never had a test. Some 345,000 have not had a test in the past 10 years. What is more, there are significant regional variations in the rates of screening. For instance, for those aged between 25 and 49, the rate of screening in London is 61.6%. In the north-east, it is 72.9%. Among over-50s, the rate in London is 74% and in the east midlands 78%. We need to look closely at those figures and find out why women do not attend. It is no use getting into the blame culture. We need to ask the right questions. Are they frightened, for example? Are appointments not at convenient times? Are there particular groups of women who do not turn up for screening? It is probably a mixture of all three.

I was sent some very interesting information from Jo’s Trust, who asked a group of young women in a survey why they did not attend for their screening. Seventy-one per cent. said they were frightened of the test and 75% said they felt vulnerable. A whopping 81% said they were embarrassed, which is a particular factor for young women who are constantly bombarded with air-brushed photos of what they should look like and what their bodies should be like, so they suffer from a lot of body consciousness. Despite the fact that doctors and nurses keep repeating, “We don’t care what you look like, we are not interested in what you are wearing, we do hundreds of these tests”, the message is not getting through. It is therefore important that tests are conducted in a supportive environment.

Interestingly, in the same survey, 67% of the women said they had felt they were not in control of the test and 68% said they would not discuss their fears with a doctor or a nurse. That particular problem applies to survivors of sexual assault: 72% are put off going for their screening or do not go at all. It is vital that women are screened in a supportive environment where they get the chance to discuss any fears they have with a practitioner beforehand.

[Anna McMorrin (Cardiff North) (Lab)]

My hon. Friend is making an excellent speech. I apologise for not being able to be here for the whole of this absolutely critical debate. Cervical screening uptake in Wales is at an all-time low. More than a quarter of women did not attend their cervical screening in the past year. Importantly, last September, Wales became the first nation in the UK to provide high-risk HPV testing as the primary cervical screening test across Wales. It leads to more sensitive and specific tests, more certainty for patients and more appropriate referrals to colposcopy services, faster treatment and then faster discharge times. Does my hon. Friend agree?

[Helen Jones]

Yes, and I hope those tests will be rolled out across the rest of Britain.

On the problem of women getting access to screening services, time and again they report that they ring their GP for an appointment that is then weeks ahead. Someone I met recently told me that, in her case, it is months ahead. It can be as much as 10 weeks. All are offered appointments at times they cannot attend, perhaps because they work shifts—that applies particularly to younger women who are more likely to be in insecure employment and therefore not eager to ask for time off.

I do not know why we persist in this, but very often the comments on screening give the impression that someone is saying, “These stupid women are not going for their screening.” Actually, there is a problem of access. I remember when we had mobile breast cancer screening units that came to a place of work. I got my blood pressure tested in the middle of Warrington shopping centre because the hospital had a programme to encourage people to go for testing in case they were at risk of vascular disease. Why can we not do more to take cervical screening to places where women are? Why can they not be screened in the workplace, for example, where groups of women are much more likely to say, “Come on! We will all go together”? It is not beyond the wit of man to arrange that.