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]
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