https://phescreening.blog.gov.uk/2018/11/30/phe-to-launch-national-cervical-screening-campaign-in-march-2019/

PHE to launch national cervical screening campaign in March 2019

The NHS Cervical Screening Programme has made a significant impact on cervical cancer mortality since it was established in 1988, saving an estimated 5,000 lives a year.

However, coverage is at a 20-year low. Figures published by NHS Digital show that, at 31 March 2018, the percentage of eligible women (aged 25 to 64) screened adequately was 71.4%.

Benefits of cervical screening infographic
Cervical screening helps prevent deaths from cervical cancer

To help address this issue, in March 2019 PHE will launch its first national multimedia cervical screening campaign.

The campaign will:

  • highlight the risks of cervical cancer
  • highlight the preventative benefits of the often misunderstood screening test
  • encourage women of all ages to respond to their screening invitation
  • encourage women to consider booking an appointment if they have missed previous invitations
  • aim to tackle issues of fear and embarrassment

It is likely there will be significant media interest in cervical cancer in the early part of 2019 due to cervical cancer prevention week (21 to 27 January) and the 10th anniversary of the death of TV reality star Jade Goody, who sadly died on 22 March 2009.

The PHE campaign will support this interest. Deciding whether to be screened is always a personal choice and this campaign will aim to help more women understand and be less fearful of taking up the offer and improve cervical screening acceptance across England. Ultimately we hope this will help stop more women getting cancer unnecessarily.

Research highlights barriers to screening

Early this year, we started to explore the possibility of a national campaign focused on cervical screening.

To take this forward, the PHE screening team has been working with our counterparts in NHS England and the PHE Marketing team that leads on the Be Clear on Cancer programme of work.

In collaboration with academics and charities, PHE Marketing has been reviewing coverage data to determine which women to prioritise and how to best tackle the issue.

In addition, PHE Marketing has conducted research with women least likely to take up the offer to understand their point of view and what they would need.

The campaign will address a number of barriers to screening highlighted by this research.

These barriers include:

  • lack of knowledge about cervical cancer and the purpose of cervical screening
  • embarrassment about the test
  • fear of pain
  • fear that the test will result in a diagnosis of cancer

Research also tells us that women feel empowered after getting screened and feel the need to protect and empower other women.

Barriers to cervical screening
Some of the reasons why many women do not attend screening

Important changes

We have made sure the information in the campaign is up to date. Cervical screening is evolving and there are many important changes, including:

Hopefully all these developments will combine to mean that one day we will be able to say that it is possible that nobody should die from cervical cancer.

We do not know for certain what response the campaign will generate but this will be an excellent opportunity to improve women’s understanding of the test and see more of them choosing to take up the offer.

Professor Anne Mackie, PHE Director of Screening said:

The Be Clear on Cancer campaign will play a vital role in raising the awareness of cervical screening, as it’s a real concern that fewer women, particularly younger women, are taking screening up.

We know that for some women worries about embarrassment or discomfort can put them off taking the test. We hope the campaign will make it clearer to them what the test involves so they can decide if it’s right for them.

We will share more information about the campaign as and when it’s available. In the meantime, please inform colleagues of the exciting news that the first England-wide cervical screening campaign will start in March 2019.

We look forward to your support.

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13 comments

  1. Comment by Laurence Carter posted on

    Its great to see this happening. I have 4 questions.

    1. Will there be a high-level framing message for the campaign? For example, something like "We're aiming to eliminate cervical cancer in [20] years This is the first major cancer we can prevent and eliminate.". ("Eliminate" and the period would need to be defined.) If this was stated up front by say, the Health Secretary or even the PM, that would provide a powerful context, and indeed would significantly raise awareness in its own right.

    2. Will the campaign aim to bring men into the conversation? At present, it seems that most outreach/literature/messaging around cervical cancer is aimed at women. But we're all fallible and indeed we know that around half of the women who miss/are late for their screening appointments both know that its important and are willing to attend - they just don't get round to it. Perhaps one way would be for their partners to remind them. Many women remind their male partners to go for, say, prostrate screening, yet I suspect that this happens hardly at all the other way round. It may be time to encourage men (or close friends) of women to remind them to go for cervical cancer screening. Suggested tagline: "Keep the women we love in our lives".

    3. Will there be complementary measures undertaken in conjunction with the marketing campagin to strengthen incentives and support for areas with poor screening coverage. For example, financially rewarding GP practices which show significant improvements in screening take up percentages (irrespective of the starting point). Or devoting extra support/resources to the bottom quartile of GP practices?

    4. Will the option of home-based self-sampling be accelerated, particularly for those women who are identified as not being willing to consider screening because they find the procedure at the GP to be unpleasant?

    I ask as someone who is spending a year walking 3,500 miles around the coast of England/Wales to raise awareness that cervical cancer is preventable. My wife died of the disease.

    regards, Laurence Carter

    Reply
    • Replies to Laurence Carter>

      Comment by Ruth Stubbs posted on

      Dear Mr Carter,
      Thank you for your comments and suggestions.
      PHE screening and immunisation teams are commissioning a disease model that will answer the question of when cervical cancer could be eliminated with reasonable certainty.
      Cervical screening is an individual choice, so the campaign will address women directly. Research with women ahead of the campaign has found there are a complex set of barriers to attendance which are specific and personal to different groups. However, there are high levels of misunderstanding about cervical cancer and the purpose of screening. The campaign will include information about the risks posed by cervical cancer and the protective and preventative benefits of screening.
      The UK National Screening Committee is currently consulting on the proposal to introduce self-sampling for cervical screening. Comments are welcome. See https://legacyscreening.phe.org.uk/cervicalcancer.
      Cervical Cancer Prevention Week and Jo's Trust's #SmearForSmear campaign are both running from 21 to 27 January. See http://www.jostrust.org.uk/ccpw.
      Kind regards,

      Reply
  2. Comment by Caroline B posted on

    You clearly state screening is a choice and then go on to say the campaign aims to ‘help women understand.’ The inference here is women who screen can’t possibly know their own mind and have made an informed choice.

    I hope the campaign will highlight and respect informed choice and health professionals will be reminded of their obligation to respect that choice.

    Reply
  3. Comment by Kat Rehman posted on

    I find it very hard to believe women aren't aware of smear tests and the issues around them and I find it even harder to believe they stay away through pain and embarrassment though if they are the current campaigns to reassure them aren't working are they? Will a new campaign really be any different from its predecessors? In a recent survey 86% of Scots women said they would prefer to self test at home. Why is this option not being rolled out here? The Dutch and Finnish women have been offered it for years. And as you state screening is a choice why are you surprised some choose NOT to test?

    Reply
  4. Comment by Duncan posted on

    "Deciding whether to be screened is always a personal choice and this campaign will aim to help more women understand and be less fearful of taking up the offer and improve cervical screening acceptance "
    You focus only on getting women screened & care little about our choice when deciding not to screen. You send the invites, that should be enough!
    Instead you continue with costly campaigns to persuade women -
    "encourage, empowered, coverage, barriers, increase uptake, choosing to take up offer"!
    What about overtreatment rates? What about more honesty?
    Doubtful you will even let my comment through as usual, unless of course I'm in favour of persuasion as I'm not allowed to dissuade!

    Reply
    • Replies to Duncan>

      Comment by Ruth Stubbs posted on

      A small proportion of women decide not to have the cervical screening test and choose to be ceased from the programme. The coverage of cervical screening – the proportion of eligible women who are screened – is 71%. This leaves around 25% of women who do not take up the offer of screening but have also not chosen to be ceased from the programme. From research, we know that factors such as appointments, timing, travel and the actual time to get the test done can prevent women from attending. For others, fear of the test and embarrassment are factors. The aim of the campaign will be to acknowledge and potentially allay some of these fears and identify obstacles that services can address to improve access.

      Reply
  5. Comment by Anthony Watson posted on

    Excellent timing. This will take place right in the middle of the process of reducing the number of cytology laboratories in the country from 49 to 9 for conversion to Primary HPV testing. Well done whoever decided to add to the chaos this is already going to cause. Exciting news indeed.

    Reply
    • Replies to Anthony Watson>

      Comment by Ruth Stubbs posted on

      Thank you for your comment. The Department of Health and Social Care (DHSC), Public Health England, NHS England and some charities identified the need for a national campaign to address the year-on-year fall in the number of women attending screening and to do our best to address obstacles for women who are missing an opportunity to prevent an avoidable cancer. We acknowledge that a campaign can impact on workloads. We sought opinion from service providers and a decision was taken to start the campaign at the beginning of March 2019 to avoid winter pressures and pressures in primary care. It is anticipated that the campaign will have a gradual impact on coverage.

      Reply
  6. Comment by cytologist posted on

    What a ridiculous time for a campaign

    Reply
  7. Comment by irene stratton posted on

    There was good take-up in Gloucester hospitals when employees were able to be screened in the hospital. Maybe having 'drop in' screening sessions would work?

    Getting an appointment at a GP surgery isn't always easy, getting there during the working day can mean taking time off work.

    Why do you need a trial about text reminders? They've been shown to work - they certainly work for diabetic eye screening - and our hairdressers and dentists wouldn't use them if they didn't work would they?

    How do you know that lesbian and bi-sexual women are non-attenders when this information isn't recorded on health records? Certainly I have never been asked about my sexual orientation by any health professional.

    Reply

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