How can we increase uptake of cervical screening?

In this blog for Cervical Screening Awareness Week (14th-20th June) our Director of Research & Services Dr Stuart Griffiths talks about recent innovations in cervical screening, and how Yorkshire Cancer Research supporters are helping to prevent deaths from cervical cancer.

Every year, around 280 people in Yorkshire are diagnosed with cervical cancer. To try to prevent cervical cancer developing, the NHS invites all women and people with a cervix aged 25 to 64 for a cervical screening appointment. The test first checks for human papilloma virus (HPV), which causes almost all cervical cancers. If HPV is found, the sample is checked for any cell changes. Not all cell changes develop into cervical cancer, but it is important to monitor and treat these changes if needed. 

Nearly 1 million women in Yorkshire are up to date with their cervical screening, which represents nearly 3 out of 4 (74%) of those invited. Although this is slightly above the average for England as a whole (72%), it means around 1 in 4 women in Yorkshire don’t accept their invitation for cervical screening.

What’s more, there’s a wide variation in attendance across Yorkshire, particularly among women aged 25 to 49. For example, in Bradford, just 69% of 25-29-year-olds attended an appointment when invited, whereas in East Riding of Yorkshire the figure was 79%. In some GP practice areas, as few as 2 in 10 women attended their cervical screening appointment. There are many reasons why people don’t attend, such as embarrassment, cultural barriers and, more recently, worries about COVID-19.

At Yorkshire Cancer Research, we are working to ensure everyone has the opportunity to attend screening, and to reduce some of the barriers people face. It is thanks to our supporters across the region that we are able to fund this work.

Louise Flanagan, our Head of Services, organised a workshop earlier this year with the Yorkshire & Humber Academic Health Science Network. The event brought together a wide range of healthcare professionals and researchers interested in cervical screening. The aim was to share innovations in cervical screening from across the country and open up discussions about how Yorkshire Cancer Research could support future collaborations to try to increase participation in cervical screening in Yorkshire.

One of the speakers was Dr Anita Lim from King’s College London. Dr Lim leads a trial called YouScreen which could provide a new way to pick up cases of cervical cancer in the future.

During a normal cervical screening appointment, a nurse uses a soft brush to take a small sample of cells from the cervix. Anita’s YouScreen study in London is looking at whether home HPV test kits - sent in the post - could be provided through the cervical screening programme. Women would use a small swab to collect a sample from their vagina and then send this back in the post to be analysed for the presence of HPV. The hope is that women who are reluctant or not able to attend cervical screening appointments could be more likely to carry out a HPV test at home. 

The YouScreen study is hugely exciting, and could see more people taking part in the cervical screening programme to prevent cervical cancer. We’re trying to figure out how we could bring a similar trial to areas in Yorkshire with particularly low cervical screening uptake.

There are other ways that we could reduce barriers to cervical screening. At the workshop, we heard from Alex Cocker and Lisa Hammond who are Screening and Awareness Coordinators for Cancer Wise Leeds. The programme, which is funded by Yorkshire Cancer Research, aims to improve screening rates in areas of the city where uptake is low. Alex and Lisa talked about how they helped set up a weekend screening hub within the Bramley, Wortley, and Middleton areas of the city. This has meant women with work and childcare commitments can attend their screening appointment at a convenient time. They also showed videos they have produced to reassure women about the safety precautions put in place during the COVID pandemic.

Local programmes like this are great at solving specific problems, but action is also needed at a national level to drive real change. We’ve been calling on the government and health leaders for more funding for screening programmes and diagnostic tests, as well as public health campaigns to encourage everyone to get cancer symptoms checked out as early as possible.

There is not one single solution that will reduce the variation in cervical screening uptake in our region – we need a range of measures. Home HPV testing is a particularly promising approach that we would like to see rolled out in Yorkshire as soon as possible. In the meantime, programmes like Cancer Wise Leeds – made possible by our supporters – are tackling specific barriers that people face when it comes to cervical screening.

Ultimately, increasing uptake of cervical screening will help to detect and prevent cervical cancer, and stop more people in Yorkshire dying too young.

Yorkshire Cancer Research encourages everyone to book a cervical screening appointment when invited. Read our blog to find out more about cervical screening in Yorkshire.