People with disabilities
People with both learning and physical disabilities have a lower participation rate in cervical screening than the general population. NHS Digital data in 2017-18 shows that people with learning disabilities had lower rates of cancer screening than those without – 31% versus 73%.
Earlier research suggested this was due to low health literacy and knowledge about the test as women with learning disabilities were found to be significantly less likely to respond to screening invitations. PHE easy guides and easy read letters are available, and Jo’s Cervical Cancer Trust also has information and resources available online.
Women with physical disabilities can also struggle to access cervical screening. In a survey from Jo’s Cervical Cancer Trust:
Dr Rebecca Leon, GatewayC GP Lead spoke to June Craven, Accessible Information Standard Patient Champion for Breakthrough UK about the barriers to cervical screening and how negative experiences can impact future attendance.
For people with disabilities, the attitudes and knowledge of both professionals and carers can play a part in the poor uptake of screening, especially in the case of cervical screening where assumptions may be made regarding sexual activity.
For physically disabled people, accessibility can be a major barrier. Healthcare professionals should support patients and consider them experts in their own care; being aware of what reasonable adjustments can be offered will also help for those people who may not be comfortable advocating for themselves.
For people with learning disabilities, information and understanding is key. Cervical screening guides are available in easy read and picture story formats (see additional information links below).
Cervical screening after sexual violence
Being invited for and having cervical screening can be particularly distressing for survivors of sexual violence. Cervical screening can trigger flashbacks or evoke physical and psychological responses – such as panic attacks, dissociation or freezing.
Survivors are also anxious about having to disclose their experience to a healthcare professional.
Homeless people, the travelling community, people seeking sanctuary and sex workers
Dr Rebecca Leon, GatewayC GP Lead met with Dr Wan-Ley Yeung, GP Clinical Lead for the Salford Primary Care Together Inclusion service to discuss groups of people that often avoid engaging with healthcare.
INTERVIEW WITH WAN-LEY
Link: Cervical screening when you have a learning disability, Jo’s Cervical Cancer Trust
Link: Health and care of people with learning disabilities: 2017-18, NHS Digital (2019)
Link: Access to cancer screening in people with learning disabilities, PLOS ONE (2012)
Link: Health and care of people with learning disabilities, NHS Digital (2016)
Link: “We’re made to feel invisible” Barriers to accessing cervical screening for women with disabilities, Jo’s Cervical Cancer Trust (2019)