Clinical update on cervical cancer.
In the UK in 2013 there were around 3,200 new cases of cervical cancer. It is the 12th most common cancer in UK women, resulting in 890 deaths in 2014. Deaths in England are more common in women living in the most deprived areas.
High-risk human papillomavirus (HPV) infection is the main potentially avoidable risk factor for cervical cancer. Anyone who is sexually active can be infected with HPV.
Cervical screening detects abnormal cells in the cervix that might develop into cancer. It prevents 75% of cervical cancers. The procedure takes about five minutes. Some women find it uncomfortable or embarrassing. Women aged 25 to 49 are invited for routine screening every three years, while those aged 50 to 64 are invited every five years.
Figures published by NHS Digital show cervical screening rates in England have fallen for the second consecutive year. Attendance rates in Wales and Scotland have also decreased.
In England in the 12 months to March 2016, 72.7% of those eligible for screening attended. This was down from 73.5% in 2015 and 75.7% in 2011.
The lowest uptake was in London (66.7%), and the highest was in the East Midlands (75.9%).
Women aged 25 to 49 years had the lowest attendance rates at 70.2%, compared to 71.2% in 2015. Among women aged 50 to 64 years, coverage was 78.0% compared to 78.4% last year.
Public Health England says it is encouraging more women to attend screening through ‘clearer information and tailored reminders’. It has asked the independent expert screening committee to consider the benefits of self-testing for women who are not taking up screening invitations.
Jo's Cervical Cancer Trust is also calling for the government to consider introducing self-testing, along with increasing the provision of screening in sexual health clinics and allowing women to attend screening at GP surgeries other than the one they are registered with.
How you can help your patient
Practice nurses play a crucial part in helping to prevent cervical cancer through the screening programme. During consultations with women, they can raise awareness of the importance of screening in preventing cervical cancer and identify individual information needs.
Building rapport with women attending screening appointments is an essential skill to ensure that they feel at ease and comfortable.
Gill Burgess, helpline coordinator, Jo’s Cervical Cancer Trust
‘Cervical screening prevents against 75% of cervical cancers so the decline in screening uptake is a significant concern. The reasons women do not attend screening are many and include fear of something being wrong, embarrassment, cultural barriers, not understanding what screening is, experiencing pain post-menopause and having a previous bad experience.
‘More needs to be done to encourage screening attendance and as nurses it is vital we take every step to ensure women do not have a screening experience that puts them off attending. Take the time to ask about any past experience, listen for signs of fear or uncertainty and talk through the sample-taking so they feel comfortable with what is going on.
‘During screening nurses have a key role in increasing knowledge about HPV and the role of screening in preventing cervical cancer. It also offers an opportunity to alleviate concerns and myths, for example, that only promiscuous women get cervical cancer and that women who have been vaccinated do not need to attend screening.
‘If we do not start to see more women taking up their screening invitation we will see increased incidence and, potentially, deaths and this is something we cannot afford to happen.'
Find out more
- Cervical Screening Programme, England – 2015-2016
- Cervical cancer statistics
- National Forum of Gynaecological Oncology Nurses
- British Gynaecological Cancer Society Annual Scientific Meeting, 15-16 June 2017, Glasgow
- Cervical screening programme targets ‘hard to reach’ women – Cancer Nursing Practice
- Benefits of opportunistic cervical screening at a sexual health clinic – Primary Health Care
- Cervical cancer: prevention, diagnosis, treatment and nursing care – Nursing Standard