Don't Fear the Smear: Tackling the Decline in Cervical Screening

Cervical cancer screening also referred to as a smear test, is a vital procedure that can detect abnormal cells in the cervix before they have the chance to develop into cancer. It’s been proven that regular screening can significantly reduce the risk of cervical cancer, and regular screening saves at least 2000 lives per year in the UK [1].? Despite this, attendance for regular screening has been steadily declining. As of December 2023, only 65.8% of women aged 25 to 49 in England attended their cervical screening appointments, with a slightly higher rate of 74.1% among women aged 50 to 64 [2].?

What’s behind the decline??

There are several reasons why some women may avoid getting screened, ranging from emotional concerns to practical obstacles. For many, the idea of a smear test can be daunting—feelings of embarrassment, anxiety, and even fear of pain often come into play. On top of that, busy schedules, difficulties booking appointments, and inconvenient clinic hours can make it challenging to find the time. There's also a common misconception, particularly among younger women, that cervical cancer is something that only affects older generations. This false sense of security, especially among those who have received the HPV vaccine, has led to a worrying trend of missed screenings [3].?

Certain groups face even greater challenges when it comes to accessing cervical screening. Women from lower-income backgrounds or marginalised communities may encounter additional barriers, such as cultural stigma, language differences, or limited access to healthcare services. Challenges such as these require thoughtful and tailored approaches to ensure that screening is accessible and comfortable for everyone.?

How can we improve screening rates??

In recent years, several initiatives have been introduced to make screening more convenient and less intimidating. One promising option is self-sampling kits, which allow women to collect their own samples at home in a private and stress-free environment. Personalised text message reminders, extended clinic hours, and culturally sensitive outreach efforts have also proven helpful in boosting attendance [4]. Education about the importance of screening—regardless of whether they’ve been vaccinated—remains crucial in combating myths and misinformation.?

Over the past three decades, the NHS Cervical Screening Program (NHSCSP) has played a key role in preventing cervical cancer. The program is free, trusted, and continuously evolving to meet the needs of the population. With the added benefit of the national HPV vaccination rollout, cases of cervical cancer have already started to decline. However, the recent drop in screening rates highlights the need for awareness.?

Cervical Cancer Awareness Month: A Time to Act?

Cervical cancer remains one of the most serious health threats to women worldwide, with HPV responsible for more than 90% of cases [5]. Regular screening remains the best way to catch any early changes and prevent cancer from developing.

As we mark Cervical Cancer Awareness Month, it’s the perfect opportunity to remind ourselves—and each other—of the importance of getting screened. Whether it’s booking your own appointment, encouraging a friend, or spreading the word, every action counts. With better awareness, improved accessibility, and continued scientific progress, we can work toward a future where cervical cancer becomes a thing of the past.?

References?

[1] Cervical screening for primary care | Cancer Research UK?? Cancer Research UK, 2024. Cervical screening. [online] Available at: Cervical screening for primary care | Cancer Research UK?

[2] NHS England, 2023. Cervical screening programme statistics. [online] Available at: https://www.england.nhs.uk/statistics/statistical-work-areas/cervical-screening/??

[3] BMJ Sexual & Reproductive Health, 2022. Why younger women are missing cervical screening. [online] Available at: https://srh.bmj.com/content/early/2022/07/15/bmjsrh-2022-201588??

[4] NIHR Applied Research Collaboration, 2023. Innovations in cervical screening uptake. [online] Available at: https://arc.nihr.ac.uk/research-areas/public-health-innovation??

[5] World Health Organization, 2023. Cervical cancer: WHO fact sheet. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer??