Wednesday, 17 June 2015

Cervical Cancer screening

This week is Cervical Cancer screening awareness week. 

Screening for various diseases has been one of the medical success stories of the last 50 years, along with vaccination programmes and improvements in drug treatments. But before they can be successful, these various tests, injections and medicines need to be proved effective and safe, and moreover, a political decision must be made to utilise them, and then political will is needed to take their use seriously.

About 3,000 cases of cervical cancer are diagnosed each year in the UK, which amounts to 2% of all cancers diagnosed in women. NHS Choices says that ‘since the screening programme was introduced in the 1980s, over 64 million screenings have taken place in the UK, and the number of cervical cancer cases has decreased by about 7% each year.’[1]

But testing cervical cancer actually began in the 1960s. One of the reasons NHS Choices talks about the ‘1980s’ is because the screening programme for cervical cancer was missing that last element of a successful medical programme for many years: political will to take its use seriously.

In 1964 the members of the WI passed a resolution urging HM Government and regional hospital boards to provide comprehensive facilities for routine smear tests. The NFWI began working to publicise the test amongst its members - members were encouraged to take advantage of screening facilities in their communities if they were available, and notified when the BUPA medical centre’s mobile unit for screening was visiting nearby.[2] At this time many women had never taken this innovative new test and information was needed to help encourage them to take this step for their health. In 1966, the National Cervical Cytology Screening Service began, which allowed the taking of smears as part of normal medical care, every five years. Priority screening was given to those over 35 and the NFWI helped distribute information about the test to members.[3] GPs were paid to carry out smears on women over 35, but were able to refuse to screen younger women who asked for a check.[4]  Women at greatest risk were not necessarily being tested, and the follow up procedures for those who had been tested positive were inefficient.[5]

The WI wanted to find out whether the cervical screening system was actually working: was it working for the women it was designed to serve? The NFWI joined the Women’s National Control Campaign, and together they began the first major survey of women’s experiences of smear testing in 1983, to discover exactly how much women knew and whether the system was working to meet their needs. In January 1987[6] the 9,000 responses were published in conjunction with Women’s National Cancer Control Campaign and the results were shocking. 65% of women had not been asked to have a smear by their doctor and that 23% had not wanted to bother their doctor to ask for one.[7]

The WI launched a campaign for better screening facilities, more public information and an effective recall system.[8] Anne Stamper, chairman of the NFWI Environment and Public Affairs Committee, pledged the WI would help educate its members, but again reiterated political decisions must be made in the interests of women if the screening programme was going to save lives:

  “Decisions on health matter are far too often made without consulting those most affected, in this case, women themselves… We are issuing an Action Sheet which WI members can use to campaign at grassroots level. And we are calling on all women to fight for better provision in their own areas. But these campaigns can only success if the government and district health authorities show a commitment to providing adequate screening facilities.”[9]

Later that year in 1988, the Department of Health launched a computerised call and recall system, and the first external quality assessment schemes for laboratories who were reading the test results. It was a big campaign win for the WI, and considered a watershed moment in cervical cancer screening – it’s the first thing listed on the timeline in the NHS publication ‘celebrating 20 years of screening’. Thanks to the WI and the Women’s National Cancer Control Campaign, cervical cancer screening was made more effective and taken more seriously. 

Today, screening saves saves an estimated 4500 lives each year,[10] and over the last 20 years the incidence of cervical cancer in England has almost halved.[11]

[1] Peto, J. et al. The cervical cancer epidemic that screening has prevented in the UK.
Lancet 364, 249-256 (2004). Quoted in NHS Cancer Screening Programmes. ‘Breast and cervical screening: The first 20 years.’
 NHSCSP 2008,[2] ‘Keeping Ourselves Informed’, p.70
[3] ‘Keeping Ourselves Informed’, p70 and Annual Report 1973[4] 1981 memo: Cervical Cancer: background information [pic 150015403 ]
[5] NHS Cancer Screening Programmes. ‘Breast and cervical screening: The first 20 years.’
 NHSCSP 2008,[6] Yip, it takes them that long to publish it (they had trouble analysing all 9000 responses).
[7] LSE Archives, Letter from RCOG to NFWI about the survey findings, photo 144654973[8] Annual Report 1986
[9] LSE Archives. Press release [124629211 photo] of the campaign launch, 13 Jan 1987
[10] Peto, J. et al. The cervical cancer epidemic that screening has prevented in the UK.
Lancet 364, 249-256 (2004). Quoted in NHS Cancer Screening Programmes. ‘Breast and cervical screening: The first 20 years.’
 NHSCSP 2008,[11]

Tuesday, 16 June 2015

For the love of... Swindon

Guest blog from Anna in Swindon WI

Tomorrow, 17th June 2015, I will be Speaking Up because climate change affects all aspects of our lives: our homes, our food, our health, and even our security.  From the frequency and severity of droughts and floods to the land available for crops, from our ability to access clean water supply to the air that we breathe – all these things are fundamental to human and wild life. And as we put ever greater pressure on our dwindling resources, we risk increased conflict globally.

I believe that we can still help to reduce this pressure by acting responsibly and swiftly on climate change. We share the responsibility for man-made changes to our world, and therefore we share the responsibility to mitigate the damage our lifestyles have done to it. We still have time to make a positive change – but we need to be honest and we need our politicians to be honest, about the extent of the problem and in the extent of action required. We need to take fast and decisive action that is collective and looks to the long game.

So along with friends from Incredible Edible Swindon, the Swindon Climate Action Network, and the WI, I will be heading to Westminster to talk to my MP about what positive action he can take as an MP on climate change. I’m looking forward to hearing his views on climate change, how Swindon can play its part in reducing UK emissions and become a more sustainable town, and how Swindon residents can get involved. 

I hope that my MP will show real commitment to making Swindon’s transport, food supply, industry, and energy consumption properly sustainable – leaving aside party politics to focus on the welfare of Swindon residents and the wider population.  I also hope that, as a Conservative MP, he will get behind calls on the UK Government to push for real commitment at COP21 from all world leaders, and real decisive action to divesting from polluting activities, while investing short and long-term measures to mitigate and reverse the damage.

But it is not just MPs who can take action on climate change.  We as individuals also have our part to play. Adapting your routine and lifestyle to be more “green” is always a work in progress and can seem daunting. Below is a list of some of the steps I take in my daily life that work for me that you can try as well:

• Improving the energy efficiency of my home: removing draughts with draft excluders, insulating the loft, hanging heavy curtains over doors and windows to keep heat in, and only heating the house when I need to.

• Reducing food miles:  buying local at local farmers markets, local veg box schemes, and growing the things I like that are a bit pricey; eating seasonally if buying in the supermarket.

• Reducing water usage/waste and the harmful chemicals I put in it: using eco-friendly detergents for washing clothes, dishes and home, and re-using my washing up water for the garden. Using rainwater to water the garden reduces mains consumption and is better for the plants as rainwater is chlorine-free. Having quick showers reduces water and heat needed – win/win.

• Sustainable transport: using public transport for longer journeys if I can and if I’m travelling alone; walking rather than driving to the shop/into town to meet friends; cycling if possible; sharing lifts if we can.

•  Reducing waste/trash: not wasting food, or composting what I can’t eat; re-using bottles/jars for home-made things and recycling anything else. Polystyrene and non-recyclable packaging is my bugbear – so I avoid buying anything wrapped-up in this stuff.

• And of course…SPEAKING UP.  On June 6th, my WI held a public bunting drop-in at a local cafĂ©, where Swindonians popped in and made bunting pennants while talking about climate change over a cup of tea.

So, For the love of… please join me and thousands of other people in London on 17th June to celebrate all that we love and to tell our MPs that we want them to take a strong action on climate change.

More information about how to Speak Up:

Friday, 5 June 2015

Climate Change Lobby on 17th June 2015

By Mary Dorrell, Norfolk Federation

We do not inherit the planet from our ancestors, we simply borrow it from our children. So, for the love of future generations, we should pass it on in as good a state as possible.

We know a thing or two about climate change in Norfolk.  In the 12th century the population of east Norfolk was growing rapidly and the area was densely populated. Trees had given way to farms and for cooking and heating the only fuel available was peat. It was a prosperous industry and provided fuel for individual families to use and good sales to local manors and abbeys. This extraction of peat changed the landscape. 

Horsey Church

The massive holes that had been created gradually began to fill with water as the sea levels rose and by the 14th century flooding was taking place on a regular basis and peat extraction was simply no longer possible. Probably the Great Storm of 1287 spelt the end of this way of life for many people in the area. The suffering must have been great. It would have been of no consolation to them that 600 years later a thriving tourist industry would employ many people in the area.

In recent times the North Sea storms and surges of 1936, 1953 and 2013 have caused death and destruction. In 1936 we nearly lost a whole Broad (Horsey Mere) to extensive flooding; in 1953, 100 people died in Norfolk; and in the 3 metre surge of 2013 we only narrowly avoided disaster by a few centimetres. Few human casualties this time, but hundreds of bewildered grey seal pups found themselves stranded on the top of the dunes.

Climate Change will bring us greater frequency of storms combined with sea level rise. There is a real threat to us, our environment, and our economy. Horsey Mere would probably be the first Broad to go, but many others would follow. And whilst Norfolk people are very adaptable, another 600 years of struggle and change is the sort of thing we want to avoid for future generations.  For the love of the Broads, we need action now.

So on the 17th June, I will be coming to London along with other people from my constituency to talk to my  MP, Richard Bacon. In the past he has been very responsive to our local flooding problems in the village where I live and am a Parish Councillor. We need to have a big conversation about this potential flooding issue: bigger than my village, bigger than Norfolk … in fact so big that we can only tackle it through international efforts. Efforts like the United Nations Climate Change Conference, to be held in Paris from 30 November to 11 December 2015, where we need our leaders to achieve a legally binding and universal agreement on climate, from all the nations of the world.

Mary Dorrell with another Norfolk WI member at Blue Wave