Smear test uptake to 'check for cervical cancer hits an all time low'

Gynaecologist holding vaginal speculum
A speculum opens up the vagina, allowing the nurse access to the cervix. [Photo: Getty]

Smear test uptake has hit a record low in the UK, with more than a quarter of women invited for a screening failing to attend, research suggests.

Screenings check for the human papillomavirus (HPV), which is behind up to 99.7% of all cervical cancers, according to Jo’s Cervical Cancer Trust.

The “Jade Goody” effect caused attendance to spike to 70% higher than normal when she died of the disease aged 27 in 2009.

More than decade on, the number of women going for a smear test has plummeted.

READ MORE: HPV vaccine could 'eliminate cervical cancer in young women'

“Cervical cancer is one of the few cancers that can be prevented through screening, and now the disease is far less common in the UK,” Michelle Mitchell, chief executive of Cancer Research UK, said.

“But these life-saving programmes can’t help people they can’t reach, which is why it’s important for us to continue to raise awareness and carry out research into how screening could be improved for hard-to-reach groups.”

Cervical cancer affects around 3,000 new women every year in the UK, Cancer Research UK statistics show.

Since the nationwide cervical screening programme was rolled out in 1988, thousands of cases have been prevented, the charity claims.

Yet, data shows the disease has risen by 54% among 25-to-29 years old.

In the UK, women aged 25-to-64 who are registered with a GP are automatically invited for a smear test.

With the cancer risk decreasing with age, women aged 25-to-49 are generally invited every three years, while those between 50 and 64 are called up every five years.

READ MORE: One in 10 women think the HPV virus is ‘dirty’

Young women, and those from deprived regions, are less likely to attend, according to Cancer Research UK.

The charity found two in five women who fail to go cite embarrassment, while one in five worry it hurts.

While some find the procedure uncomfortable, it should not be painful.

One who knows the importance of smear tests all too well is cancer survivor Gen Sofianos.

The 32-year-old Londoner was diagnosed with stage one cervical cancer following a screening in 2015.

“I was young and healthy, and hadn't experienced any symptoms, so to be told I had cervical cancer took me completely by surprise,” she said.

Following surgery a month later, Ms Sofianos is in remission.

“The test takes just minutes and can save lives; I believe it saved mine,” she said.

“Had I left it a few more months, I might be facing a completely different battle with a very different outcome.”

Gen Sofianos was diagnosed with cervical cancer following a smear test. [Photo: Cancer Research UK]

What does a smear test involve?

A smear test involves a nurse placing a speculum in a woman’s vagina to hold it open, allowing the healthcare professional access to the cervix.

Using a soft brush, a cell sample is taken, which gets tested for HPV.

HPV is a common virus that infects four in five Brits at some point in their lives, according to Jo’s Cervical Cancer Trust.

Once infected, via sexual contact, most fight off the virus naturally.

Yet, of the more than 200 HPV strains, 13 have been linked to cancer.

After a smear, the next step depends on whether HPV is detected. Results are usually available within two weeks.

If HPV is present but no cell changes have occurred, most are invited for a second screening in a year’s time.

When cell changes are abnormal, a woman may be invited for a colposcopy, which allows for closer examination of the cervix.

READ MORE: Urine test could mark the end of smear tests

Around 40% of colposcopy results come back clear, according to Jo’s Cervical Cancer Trust.

In very rare cases, colposcopies reveal a woman has cancer.

Most of the time, they show up abnormalities on the cervix’s surface.

This is usually treated via large loop excision of the transformation zone (LLETZ).

LLETZ involves using a thin wire loop with an electrical current to remove the area of the cervix with cell changes.

The removed area is then sent off for tests to determine the extent of the cell abnormalities.

If cell changes are higher up the cervical canal, a thin straight wire is used rather than a loop.

Alternatively, a cone biopsy may be carried out to remove a funnel-shaped piece of tissue from the cervix.

If abnormal cells remain, lasers or heat may be used to “burn” away the affected tissue.

Extreme cold cryotherapy could also help.

Nine in 10 women do not have abnormal cell changes again after the above treatments, according to Jo’s Cervical Cancer Trust.

The charity adds around three quarters (75%) of cases are prevented due to screening.

Along with the HPV vaccine, smear tests are “the best way to protect against” the disease.