Record numbers of women are not being screened for cervical cancer, official figures show, as a leading charity urged ministers to commit to eliminating the disease.
Cervical cancer is the 14th most common cancer among women in the UK. About 3,200 women are diagnosed with it each year, of whom more than a quarter die.
It is highly preventable through human papillomavirus (HPV) vaccinations for 12- to 13-year-olds and cervical screening. Screening involves taking a small sample of cells from the cervix and looking for high-risk HPV that could develop into cancer if left untreated.
The latest NHS England data shared exclusively with the Guardian show that about 4.6 million women aged 25 to 64 in England (or 30%) – amounting to the highest proportion in a decade – have never been screened for cervical cancer or are not up to date with their tests.
At the same time, vaccination rates among teenagers are falling. For 2021/22 they were down 7% in girls in year 8 at school, and 8.7% in year 8 boys, compared with the previous academic year.
The figures come as research by the charity Jo’s Cervical Cancer Trust, published on Monday, finds that only 16% of those working in the cervical cancer sector believe that enough is being done to support cervical screening uptake, while only 20% think enough is being done to ensure high HPV vaccination rates.
With half of all cervical cancers occurring among women who have never been screened or who are under screened, the charity fears that without concerted action more women could die.
“We want to see the government step up and commit to eliminating cervical cancer in the UK,” said Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust. “Other countries are much further along the path to ending this cancer and we do not want the UK to fall behind. Addressing inequalities in access to cervical screening and uptake of HPV vaccination is vital.”
NHS England called for anyone eligible for cervical screening to get their test.
Dr Kiren Collison, GP and NHS interim medical director for primary care at NHS England, said: “We have the opportunity to eliminate cervical cancer altogether. Having the potential to completely eradicate a disease that affects thousands of people every year is remarkable, but in order to do this it is vital that people take up the offer of a test – so if you have received an invitation, or missed your last screening, don’t wait to make an appointment – getting checked can save your life.”
Cancer Research UK’s head of health and patient information, Julie Sharp, said: “Some people can find cervical screening uncomfortable or painful but there are ways to make your appointment work better for you. When booking, ask for a longer time slot, so you can speak through any concerns you may have. And remember, you are in control of your appointment. You can ask the nurse to stop at any time, for a different sized speculum or to try lying in a different position.”
In 2019, the NHS introduced a more sensitive test, and in London is trialling at-home self-screening for cervical cancer, which could be rolled out nationally.
More than two-thirds of people surveyed in the Jo’s Cervical Cancer Trust report said HPV self-sampling gave one of the biggest opportunities to eliminate cervical cancer in the UK.
Most of these tests are performed at GP practices, or at sexual health clinics. For women who need to travel to their GP surgery, who have full-time work or childcare commitments, or disabilities, the lack of choice in where to access screening could hinder take up, the charity’s report found.
Prof Peter Johnson, NHS England’s national clinical director for cancer, said: “There are lots of reasons why somebody might not want to come forward – embarrassment, inconvenience, uncertainty – but please speak to a healthcare professional if you are unsure.”
Maria Caulfield, minister for women’s health, said: “I have seen firsthand through working as a nurse in a cancer unit how important it is to detect this cruel disease early, and the NHS cervical screening programme is a vital way of detecting risk of and preventing cervical cancers.
“We’re improving the cervical screening process, including opening up 24/7 laboratory screening and expanding the locations options available so people can get their results faster and their tests easier. I encourage those eligible to attend their potentially life-saving screening when invited.”
Case studies
Hayley Prince, in her 40s, from Manchester
“I put off my smear test. As a single, working, mum, I often could not get an evening appointment so, as life got busier, making the appointment ended up being something I completely forgot about. It was Jade Goody’s passing that jogged my memory to go. When I was diagnosed the only word I heard was ‘cancer’ and I broke down. I had a radical hysterectomy and they found it had spread to my lymph nodes in my groin, so I had chemotherapy and radiotherapy too. It’s so important that we stop as many people as possible from going through what I have. We’re now at an all-time low of cervical screening uptake, but we can change that.“
Syeda Nusrat, 41, from Yorkshire
Nusrat said she did not pay attention to her screening invitations as she did not know what the procedures involved, nor was women’s sexual and reproductive health outwardly discussed within her Pakistani culture. “There are so many myths attached to cervical screening and women’s health [that] make people fearful. But the reality is far different as my experience was very straightforward and it has made me more open to coming forward for other checks, like mammograms.”
