1. Cervical Screening: Improving Uptake
Dr susanna Unsworth
Women’s health gp – angel hill surgery, bury st edmunds

2. Cervical Cancer
Every day in the UK 9 women are diagnosed with cervical cancer
Every day in the UK 3 women will die from the disease
Cervical cancer is the most common cancer in women under 35 years
Cervical screening prevents up to 75% of all cervical cancers

3. NHS Cervical Screening Programme (NHSCSP)
Introduced in 1988
Current programme
25-49 years – 3 yearly recall
50-64 years – 5 yearly recall (ending when most recent result negative, with normal recall and next date falls after 65th birthday)
Uptake rates
1989 – 40%
2008/9 – 79.8% - ‘Jade Goody’ effect – extra 400,000 tests
Currently at its lowest rate for 20 years!

4. Why are women not attending?
Almost 3.7 million women missed their screening appointment in the last 5 years – this is 1 in 4 women.
WHY?

5. Why are women not attending?
Knowledge about the test
Fear of the test
Access to Appointments

6. Knowledge about the test
Unaware of screening programme
Women from ethnic minority groups
Women with learning disabilities
Not recognising they are at risk
Older single/divorced women
Understanding the role of HPV (human papillomavirus)
HPV Primary Screening
Unaware of symptoms of concern
Abnormal bleeding/discharge, pain on intercourse

7. Fear of the test Younger women not knowing what to expect
Social media, horror stories
Previous experience
Fear of the result
HPV positive result – ‘have I got an STI?’
Pain following the menopause
Vaginal atrophy

8. Access to appointments
Difficulty getting appointment at surgery
Inconvenient times, cancellation
Lack of employment flexibility to attend
Day time appointments, nurse running late
Other responsibilities eg childcare
No female sample takers
Particularly ethnic minority groups

9. What are we doing at Angel Hill?
All new women registering are contacted by practice nurse
Monthly review of non-attending women with a letter inviting them
Text reminders of appointments
Variable appointment times with nurses
Jo’s Trust Posters in all waiting areas
Where possible, screening done opportunistically
Educated practice nurses
Women’s Health Specialist GP – Me!