Background information

Over the past ten years there has been a decline in the number of women taking up their offer of cervical screening. Lower attendance is particularly evident in the youngest, as well as the oldest, age groups and in under-represented groups such as those from lower socio-economic and ethnic minority communities.

Additionally, an independent review of national screening programmes found that 17% of cervical samples were not prompted by the screening programme but were ‘opportunistic’ samples taken when women presented to primary care – usually at sexual health clinics, however this provision is not always available as services are commissioned through local authorities.

Participation, Engagement and Experience

Things needs to change – by informing understanding and improving experience we should be able to increase uptake.

You can encourage informed participation in cervical screening by:

• Improving awareness of the screening programme
• Encouraging re-attendance when invited, even if previous tests have been normal
• Discussing potential barriers
• Engaging with non-responders
• Discussing opportunistically at other healthcare appointments
• Using different communication methods to engage with patients, such as texts, telephone calls and targeted letters

Patients are also less likely to re-attend cervical screening if they have a negative experience.

Dr Rebecca Leon, GP Cancer Lead, speaks to Kate Sanger, from Jo’s Cervical Cancer Trust on how to improve cervical screening uptake and patient experience.

VIDEOS TO BE COMBINED

Advertising campaigns and public awareness

In early 2022, the government launched a new national cervical screening campaign. The campaign promoted screening participation as it was revealed that nearly 1 in 3 don’t take up their invitation.

National campaigns, with endorsement from public figures, have previously had a notable impact on cervical screening attendance. An increase in cervical screening attendance in 2009 became widely known as the “Jade Goody Effect” following Goody’s death from cervical cancer. This increase was seen across the whole range of ages, but was driven by younger women, women from lower socioeconomic backgrounds and women with young families who were closest to Jade Goody in age or circumstances. It was thought that this narrative communication may be an effective way to encourage attendance.

While the spike in participation has been declining, it is clear that public awareness and open discussion are key to improving uptake, particularly amongst groups of the population that are under-represented.

National campaign resources are available here

Additional information

Link: Report of the independent review of adult screening programmes in England, NHS England 2019
Link: Primary Care Good Practice Guide: Cervical Screening, Cancer Research UK
Link: Screening for cervical cancer, BMJ Learning
Link: Barriers to cervical screening, Jo’s Cervical Cancer Trust
Link: Improving access to cervical screening, Jo’s Cervical Cancer Trust
Link: Increasing the uptake of cervical screening at Cornerstone Medical Practice (BMJ, 2021)
Link: GP Mythbuster 104: Cervical screening, Care Quality Commission
Link: New national cervical screening campaign launches, gov.uk
Link: Cervical screening campaign resources, Public Health England
Link: The impact of Jade Goody’s diagnosis and death on the NHS Cervical Screening Programme, Journal of Medical Screening (2012)
Link: The Jade Goody Effect: whose cervical screening decisions were influenced by her story?, Journal of Medical Screening (2012)