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Coronavirus UK: Thousands of women miss cervical screening

Up to half a million women have missed cervical smear tests during the coronavirus pandemic and the NHS will be under ‘huge pressure’ to catch up, a charity warns.  

Smear tests are quick, life-saving screenings which spot cell changes that can lead to cervical cancer, and would usually be carried out 600,000 times in April and May.

But many of the tests have been cancelled or postponed because of the Covid-19 pandemic and women’s health is at risk as a result. 

The charity Jo’s Cervical Cancer Trust found that four out of 10 women are worried they haven’t been able to go to the routine appointments. 

It did not say exactly how many routine appointments have been missed but services have been paused completely in Scotland, Wales and Northern Ireland, and many have been postponed in England. 

Only one in seven women said they would still feel safe going for their smear, the charity found, while one in eight said they felt it was ‘best not to go at the moment’.

Smear tests are available to all women between the ages of 25 and 64, and others outside that range in some circumstances, and is one of the NHS’s major cancer-prevention screening programmes.

The appointments, however, are not urgent procedures and rely on physical contact between the patient and medical worker meaning many have fallen by the wayside. 

The charity’s warning comes amid concerns of a cancer ‘time bomb’ building up during the crisis because normal NHS operations have been put on hold. Millions of people are still waiting for tests or treatment for the killer diseases. 

A cervical cancer charity has warned that 1.5million women miss cervical screenings even in a good year and the coronavirus pandemic has made 2020 even worse (stock image)

A cervical cancer charity has warned that 1.5million women miss cervical screenings even in a good year and the coronavirus pandemic has made 2020 even worse (stock image)

A normal year would see around 1.5million women miss a smear test they are eligible for and this year will be even worse, Jo’s Cervical Cancer Trust warned.

Its chief executive, Robert Music, said: ‘Cervical screening isn’t always the easiest test and we must try to prevent coronavirus making it even harder. 

‘We want every woman to have the information and support they need to feel able to make decisions about their health. 

MORE THAN 2MILLION PEOPLE WAITING FOR CANCER TESTS OR TREATMENT 

Cancer Research UK has warned more than two million people in the UK are waiting for cancer screening, tests or treatment because of healthcare disruptions in lockdown.

It said 2.1million people are now waiting for screening appointments for either cervical, bowel or breast screening.

For every week that screening programmes are paused – as they are in Wales, Scotland and Northern Ireland – some 7,000 people miss out, CRUK said.

And 380 cancers that would normally be picked up through these screening programmes are being missed, the charity said.

Meanwhile, some 12,750 people across the UK are waiting to have cancer surgery and the number of operations being carried out has fallen to 60 per cent of normal levels.

Hospitals have had to reduce treatments for non-coronavirus patients to keep more beds free for people sick with Covid-19.

Six thousand fewer people than usual have started chemotherapy during recent weeks, the charity added.

Professor Charles Swanton, chief clinician at Cancer Research said: ‘Delays to diagnosis and treatment could mean that some cancers will become inoperable.

‘Patients should need to wait for this to be over before getting the treatment they need. We can create a safe environment for both staff and cancer patients if [coronavirus] testing efforts ramp up quickly.’   

‘This includes understanding the measures GP practices and sexual health services are putting in to keep patients safe. 

‘For those working in primary care, being mindful of new concerns as a result of coronavirus is important to ensure the right support can be given to women due cervical screening.’

Screening programmes have been paused completely in Scotland, Wales and Northern Ireland during the pandemic and are still not running.

In England, many clinics have postponed smear tests but the system is still operating and women are urged to contact a doctor if they develop symptoms such as unusual bleeding or pain.

Jo’s Cervical Cancer Trust found that 12 per cent of women said they were less likely to attend a cervical smear test than before the coronavirus pandemic.

Fear of contracting the coronavirus while at the doctor’s surgery, not wanting to add strain to the NHS and uncertainty about how the procedures would work now were among their top concerns.

GP surgeries are still able to do the screenings in the same way – inserting a swab into the vagina to get a sample of cells from the cervix, which usually takes less than a minute.

The difference is likely to be that there are social distancing measures in the surgery and the doctors and nurses are wearing protective equipment such as masks.

One woman who has had a smear test during the lockdown, who gave her name as Joanne, said: ‘Both myself and the nurse doing my smear test were wearing protective items and there was only myself in the building. 

‘I was nervous because of Covid but also didn’t want to risk my health by not attending my regular smear testing. 

‘I did ask the GP if it was better to wait until lockdown eases and they replied that I would be fine and they are taking every precaution to keep staff and patients safe.

‘I was in and out within 10 minutes and got my peace of mind as my results were all okay.’

The charity’s findings, which were based on a survey of 851 women, are concerning because uptake of cervical screening is lower than it should be even at the best of times.

Data published in November showed that 2018-2019 was the first time in five years that attendance at the appointments had started to rise.   

Almost 11million women between 25 and 64 had routine cervical screening tests in 2018-19 – more than at any time since 2011.

HOW MANY WOMEN ATTEND THEIR CERVICAL SCREENINGS? 

In England cervical smear tests are offered to women between the ages of 25 and 49 every three years, and every five years for those between 50 and 64. Over-64s are only invited to routine appointments if they have had an abnormal result in the past.

NHS statistics show how attendance has changed over the past eight years: 

2011 – 75.7% of eligible women (10.28million total attendances)

  • 2012 – 75.4% (10.35m)
  • 2013 – 73.9% (10.10m)
  • 2014 – 74.2% (10.35m)
  • 2015 – 73.5% (10.41m)
  • 2016 – 72.7% (10.46m)
  • 2017 – 72% (10.57m)
  • 2018 – 71.4% (10.67m)
  • 2019 – 71.9% (10.92m)

Source: NHS Digital 

That represented 71.9 per cent of all those who were invited to the tests and marked a small rise from 71.4 per cent the year before.

That percentage had been falling almost constantly for eight years and only rose once during that time – in 2014.

Health experts said it was promising to see an increase but the good news shouldn’t distract from the issue of more than a million women choosing not to go.

Cancer Research UK has warned more than two million people in the UK are waiting for cancer screening, tests or treatment because of healthcare disruptions in lockdown.

It said 2.1million people are now waiting for screening appointments for either cervical, bowel or breast screening.

For every week that screening programmes are paused – as they are in Wales, Scotland and Northern Ireland – some 7,000 people miss out, CRUK said.

And 380 cancers that would normally be picked up through these screening programmes are being missed, the charity said.

Professor Charles Swanton, chief clinician at Cancer Research said: ‘Delays to diagnosis and treatment could mean that some cancers will become inoperable.

‘Patients should need to wait for this to be over before getting the treatment they need. We can create a safe environment for both staff and cancer patients if [coronavirus] testing efforts ramp up quickly.’  

WHAT IS A SMEAR TEST?

A smear test detects abnormal cells on the cervix, which is the entrance to the uterus from the vagina.

Removing these cells can prevent cervical cancer.

Most test results come back clear, however, one in 20 women show abnormal changes to the cells of their cervix.

In some cases, these need to be removed or can become cancerous.

Cervical cancer most commonly affects sexually-active women aged between 30 and 45. 

In the UK, the NHS Cervical Screening Programme invites women aged 25-to-49 for a smear every three years, those aged 50 to 64 every five years, and women over 65 if they have not been screened since 50 or have previously had abnormal results.

Women must be registered with a GP to be invited for a test. 

In the US, tests start when women turn 21 and are carried out every three years until they reach 65.

Changes in cervical cells are often caused by the human papilloma virus (HPV), which can be transmitted during sex.  

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