In November 2017, it was reported that the number of women in the UK receiving cervical-cancer screenings, or smear tests, had reached a 20-year low. With cervical cancer being the most common form of cancer in women below the age of 35, and smear tests making it one of the more preventable strains, this worrying trend poses a very real threat to, and a sad regression for, women’s health. So, what’s causing it?
According to a report published this week by the UK’s only dedicated cervical cancer charity, Jo’s Cervical Cancer Trust – and ahead of Cervical Cancer Prevention Week, which starts today – body shame could be a major factor. Of the 2,017 women surveyed as part of their report into the dwindling figures, 35 per cent cited embarrassment as the primary reason for avoiding their appointments. Delving deeper, some worrying insights emerged about the specific body hang-ups driving the trend. Of those avoiding their appointments, 50 per cent claimed weight or body shape was the main reason for embarrassment, while 54 per cent cited their concerns about not having a “normal” smell. Most surprising of all, however, was that 48 per cent of women also cited concerns and anxiety about the appearance of their vulva.
With negligence towards cervical health more common among the 25-29 age group (of which, one in three eligible women fail to take up their cervical-cancer screening invitation), the influence of the internet, porn and the designer-vagina trend seems difficult to ignore. That these factors are distorting both men and women’s expectations of how a vagina should look is well documented and nothing new, but this is perhaps the clearest indication we have so far of how damaging it might be – risking the health of an entire generation of women, due to the misplaced sense that their reproductive organs are in some way abnormal.
Although an NHS representative has issued a statement saying the organisation’s intent is to make women feel as welcome and comfortable as possible in spite of these anxieties, there’s no denying that a wider societal shift has to take place before the trend worsens.
“We always talk to the woman while she is fully dressed, so she is aware of what is going to happen,” explains Jilly Goodfellow, senior sister and nurse practitioner for colposcopy and gynaecology at the Royal Victoria Infirmary in Newcastle upon Tyne Hospitals NHS Foundation Trust. “We also explain the reasons for the smear, when she will receive the result and what it will mean. A chaperone is always offered and, if they would like a friend or partner with them, this is fine, too. The majority of sample takers are female nurses, who fully understand what it is like to expose the most intimate part of their body to a complete stranger.”
While potentially awkward and momentarily uncomfortable, it’s important to remember that cervical-cancer screenings are simple, straightforward and over within minutes
The NHS cervical screening programme (NHSCSP) is one of the most advanced systems within the health service, with all women of a screenable age included in a process of call, follow-up and feedback. At the age of 25, all those living with female reproductive organs – and therefore susceptible to pre-cancerous cells – will have been contacted to attend their first screening. One worry is that with present cuts and widespread outsourcing of the NHS to private sector clients, this automated messaging and appointment system could be at risk. How long the organisation can shoulder responsibility for women attending their screenings is uncertain.
I was unable to gain a clear picture of how the NHS or Public Health England plan on tackling this issue. After several unanswered calls and deflected responses, I was finally able to speak to a representative from the latter, who explained:
“Focus groups have shown us that a lot of women avoid the test due to several factors, including embarrassment, concern about the test itself and apathy. Anecdotally, we’ve found that many women believe that, after their first positive test, it isn’t necessary to follow up with another, for example.”
Public awareness of cervical cancer has certainly seen a drop-off in the immediate wake of Jade Goody’s death, almost a decade ago, in 2009. In March of that year, attendance for cervical-cancer screenings was 70 per cent higher than expected. We cannot wait for another high-profile tragedy to have the same effect.
While potentially awkward and momentarily uncomfortable, it’s important to remember that cervical cancer screenings are simple, straightforward and over within minutes. What’s more, the doctors and nurses who conduct these procedures have seen it all – there is no feature under the sun that isn’t common to women all over the country and seen hundreds of times a day by medical professionals. So, check your status and book an appointment if one is due by contacting your GP or going to your local NHS walk-in centre.
For more information, questions and help, you can also visit Jo’s Cervical Cancer Trust