Nurses need to do more on cervical screening as Jade Goody effect fades
Ten years on the Jade Goody factor may have waned, but nurses can do more to encourage women to make an appointment
The Jade Goody effect on cervical cancer screening may have faded, but nurses can do more to encourage women to make an appointment
Jade Goody had an enormous impact on cervical screening. The reality TV personality was only 27 when she died of cervical cancer in 2009, leaving behind two children.
But her death spurred on a generation of women to attend screening. In the year she died coverage increased to 78.9% in England with around 400,000 more women booking a test. In addition to the initial spike we saw many coming back for another appointment.
Ten years on attendance is lower, having fallen to 71.4% in 2018.
Health reforms to blame
Health reforms are in part to blame. I was the nurse consultant for public health in my area five years ago and would visit GP surgeries encouraging them to do audits as well as undertaking screening in outreach clinics.
Budget cuts and commissioning changes mean these roles are gone, and venues that used to offer screening – including on sexual health – are no longer able to do so.
Every time there is a national campaign, including those run by Jo’s Cervical Cancer Trust and Public Health England’s Cervical Screening Saves Lives campaign, we see surges in women booking appointments.
Fear and confusion
We have been inundated over the past few months and this is fantastic to see. However, as we have seen following Ms Goody’s death, if activity is not sustained increases will be short-lived.
Cervical cancer prevention is constantly changing, most recently with human papillomavirus (HPV) testing and vaccination of boys, and hopefully soon with self-sampling, which will get women back into screening.
Ten years ago, there wasn’t much discussion about HPV. These days we have a much better idea about the virus and its link to cervical cancer, but now we see fear and confusion and, sadly, stigma about it. This needs tackling, and as nurses we can play a role in that.
Embarrassment about screening
I feel that the HPV vaccine was presented wrongly when it was introduced, as many people thought it prevented cervical cancer. It discouraged people from going to screening as they had had their ‘cancer jab’.
‘It’s our role as nurses to make people feel comfortable and ensure women know there are ways they can make it easier’
There’s so much embarrassment about screening too. Embarrassment is perfectly normal, but it’s also normal to go for the test. It is our role as nurses to make people feel comfortable and ensure women know there are ways they can make it easier.
We could encourage women to book an appointment to simply talk about the test or to let them know there are different sizes of speculums, for example.
Taboos and stigma
The barriers to attendance are many, but booking a test should not be one. At our practice we are trying to combat this with better opening hours and having extra weekend and evening appointments, held specifically for screening.
There are practices where the staff do not think they have the time to take measures such as calling non-responders, but we have been seeing great results from such phone calls and find it worthwhile. The personal touch goes a long way.
Celebrities have a huge influence and by sharing their experiences and using their platforms they can help break down taboos and stigma about the test itself as well as raising awareness of cervical cancer risks. It was tragic to witness Ms Goody’s death and we should not need another death to create this effect.
Jenny Greenfield is nurse manager in a GP practice in East Sussex, a cervical screening trainer and a member of the Jo’s Cervical Cancer Trust expert panel
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