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    General Practitioner: If You Delay Smear Test, You’re Putting Yourself at Risk

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    It’s Cervical Cancer Prevention Week, and GPs all over the UK are urging women to attend smear tests. Sputnik spoke about it to GP ambassador for Jo's Cervical Cancer Trust Dr Philippa Kaye and Professorial Research Fellow in Behavioural Science at University College London Dr Jo Waller.

    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.

    Dr Jo Waller: Our work has shown that you can divide women into different groups on the basis of the reasons why they don't attend cervical screenings. So first of all, there are people who are not aware of the screening programme, they don't know much about cervical cancer and just aren't really aware that the screening offers are there at all. And then there are people who've made an active decision not to go — so this can be because they don't feel at risk, or because they've had a bad experience with screening in the past, or they don't like the procedure.

    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.

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    Sputnik: How does the screening programme work?

    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.

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    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.

    And then, for those women who are inclined to go but don't get around to it, the things we can do there are around making it as easy as possible for people to go for screening, if they want to; so trying to be flexible about appointment times — I know that Jo's Cervical Cancer Trust, the charity, are doing work to try and ensure that screening is offered author in sexual-health clinics and women clinics, as well as in primary care; so that women have different options as to where they get checked. And those organizations, so Jo's Cervical Cancer Trust, the NHS website and Cancer Research UK all have really great information for women who are making decisions about screening, and about what the appointment involve and what to expect.

    The views expressed in this article are those of the speakers and do not necessarily reflect those of Sputnik.

    The views and opinions expressed in the article do not necessarily reflect those of Sputnik.

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