Cervical Cancer Smear Tests

Louise Haigh Excerpts

Monday 28th January 2019 Westminster Hall

[Helen Jones]

I will answer that point in a moment, because it is important that we look at the evidence. There will always be some cases, even among women under 25. We can never eliminate the risk completely. When that happens, it is important they get the right treatment. That is why in 2010 guidelines were published for GPs to ensure that young women who presented with abnormal symptoms were offered screening and referred on to a consultant if necessary. That does not always happen—I will come on to that in a moment.

[Louise Haigh (Sheffield, Heeley) (Lab)]

I apologise that I cannot stay for the whole debate. What monitoring is done of GPs providing that screening, including for women over the age of 25? I had a smear that presented as abnormal. I had HPV. I went to my local GP and asked for my smear test that I was required to have and was told that they did not do smear tests. What monitoring is being done to ensure that all GPs are adhering to the guidance and their duties under the legislation?

[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.