Sputnik: What factors push women to avoid cervical screenings?
Dr Philippa Kaye: The general reasons that they are giving are fear: some of that is fear that they're going to have cancer, some of that is fear of the test, fear of pain. They also are very embarrassed, and they mentioned what they look like, what their hair is like, they're worried about an odour, and they were also worried about not feeling in control.
And even if they have those worries and those feelings of being very vulnerable, two-thirds of them don't tell the healthcare professional that is doing the test. They're worried that they're going to be considered that they're making a fuss or that their concerns are too silly, and that people will think less of them. So, even when they have anxieties they are then worried about talking about them.
And then by far, the largest group is women who have actually decided that they will go for screening and they're positively inclined toward screening, but they put it off or they don't get around to it. And that's often to do with aspects of the screening procedure, like the convenience of being able to make an appointment or just the competing priorities in their lives. So there's a whole range of reasons across those different types of women.
Sputnik: As Dr Kaye pointed out, the fear of finding out that something is wrong with their body is a major factor that puts off women from taking a smear test. But wouldn't this self-neglecting behaviour increase their risk of developing cervical abnormalities?
Dr Philippa Kaye: Absolutely. But a cervical screening, a smear test, doesn't check for cancer. What it does is it checks for changes that could possibly turn into cancer, and the whole advantage of it is that we can do something about those cells, we can treat those cells to stop you getting cancer later on — and that's why it's so important that women attend their screening.
Dr Philippa Kaye: What we do know is that there are about 3,200 cervical cancer diagnoses in the UK every year. Of those very few, less than 100 of them, are women under the age of 25. And that's why the screening programme starts at the age of 25. It's also extremely rare over the age of 65. And that's why the screening programme stops in the UK at 65.
What we do know though, is that in between that, we run it every three years between 25 and 49, and then every five years between 50 and 64 — because the instance then does begin to decrease. If we want it more often, if you have a test annually or every two years, we know that you're not actually picking up that many more cases that need treatment, and you're causing a bigger burden on women by asking them to come every year. What that means though, is that we know that this is about the right length to pick up the most number of cases without missing any. So if you delay your smear when you have your invitation letter, you're putting yourself at risk.
Sputnik: So what can be done to motivate women to undertake smear tests?
Dr Jo Waller: Going back to the three different types of women I talked about in the beginning. So the first ones, who are unaware, I think it's about giving people information; getting them to engage with the idea of screening, and to ensure that they're informed about the offer of screening that's there. For women who've made a decision not to go, it's trying to ensure that they are making an informed choice, based on good information. So things like making sure that unanswered questions about the screening procedure are addressed; that women know what to expect; that issues around embarrassment and anxiety about the procedure being uncomfortable are addressed.
The views expressed in this article are those of the speakers and do not necessarily reflect those of Sputnik.