More than 250,000 women in Greater Manchester missed their latest cervical screening, commonly referred to as a smear test. The revealing figures come as, in certain areas of the country, some 1 in 2 women and people with a cervix don’t attend cervical screening when invited, according to cervical cancer experts.
Invitations for cervical screening were suspended in April 2020 due to the Covid-19 pandemic and resumed from June 2020. While those with symptoms or previous history were still seen, checks were put on hold for those who were lower risk.
Across England, just 67.9 per cent of those aged 25 to 49 invited to screening had had a test in the previous three years as of March last year. That was the lowest level since records began in 2002.
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Cervical screening checks a sample of cells from the cervix for certain types of human papillomavirus (HPV). These types of HPV can cause abnormal changes to the cells, which can go on to cause cancer, and are called "high risk" types of HPV.
If these types of HPV are found during screening (an HPV positive result), the sample of cells is then checked for abnormal changes. If abnormal cells are not treated, they may turn into cervical cancer.
Rates had improved slightly in March 2020, when 70.2 per cent of those in this age group had been tested. However, generally the proportion going to their screening has been falling since a high of 74.0 per cent in March 2010 - a peak most likely due to the Jade Goody effect, following publicity around the reality star’s illness and death from cervical cancer in March 2009.
At the end of December last year in Greater Manchester, a third of women and people with a cervix aged 25 to 49 (33.6 per cent) and more than a quarter of those aged 50 to 64 (26.9 per cent) were not up to date with their cervical screening. Screening coverage for those aged 25 to 49, who should be tested every three years, was 66.4 per cent in Greater Manchester at the end of December 2021, which was down from 66.9 per cent in December 2020, and down from 70.2 per cent in December 2019.
The proportion of 25 to 49-year-olds who had been screened as of December 2021 was the lowest it has been since records began in March 2013. That means of those eligible to be screened, 185,833 in this age group in Greater Manchester were not up to date with the vital health check at the end of last year.
Meanwhile, those aged 50 to 64 should be tested every five years. In Greater Manchester, 73.1 per cent of those in this age group were up to date with screening at the end of December, leaving 66,460 unchecked, which was down from 73.6 per cent in December 2020, and down from 75.5 per cent in December 2019. December 2021 saw the lowest level of coverage for this age group since at least March 2013.
Samantha Dixon, Chief Executive, Jo’s Cervical Cancer Trust, said: “Cervical screening is vitally important – it can help to stop cancer before it starts, saving lives. Yet in some parts of the country, as few as 1 in 2 women and people with a cervix don’t attend cervical screening when invited.
“This can be for a number of reasons. Some aren’t able to find an appointment that fits around work commitments, while some feel anxious or embarrassed. Others may have experienced sexual violence, or are living with endometriosis, menopause or vaginismus.
“This #CervicalScreeningAwarenessWeek, we’re talking about the importance of attending your cervical screening – and a huge part of this is helping everyone to feel supported and included in the process.”
Returning to the national picture, among those aged 50 to 64, 72.1 per cent had been tested in the previous five years as of March 2021, down from 74.6 per cent in 2020 and 74.8 per cent in 2019. It was the lowest rate in 20 years.
Sarah Price, Interim Chief Officer, Greater Manchester Health and Social Care Partnership said: “There are a number of reasons why people do not come forward for cervical screening (smear test). The pandemic has had a significant impact and additional issues like fear, embarrassment, busy lives and sometimes lack of knowledge of what the test is for and how important it is.
“The screening and immunisation teams in Greater Manchester are working closely with GP practices to contact people who have missed their appointments and offer evening or weekend appointments where possible. We are also piloting some additional sites for people with learning disabilities and autism.
"Screening only lasts a few minutes, and you only have to go once every 3 or 5 years depending on your age. We urge people in Greater Manchester to take up the screening offer as soon as they receive their letter and if they have missed a previous appointment to book with their GP practice straight away.”
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