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Cervical Screening: Improving Uptake. Dr susanna Unsworth Women’s health gp – angel hill surgery, bury st edmunds. Cervical Cancer. Every day in the UK 9 women are diagnosed with cervical cancer Every day in the UK 3 women will die from the disease
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Cervical Screening: Improving Uptake Dr susanna Unsworth Women’s health gp – angel hill surgery, bury stedmunds
Cervical Cancer • Every day in the UK 9 women are diagnosed with cervical cancer • Every day in the UK 3 women will die from the disease • Cervical cancer is the most common cancer in women under 35 years • Cervical screening prevents up to 75% of all cervical cancers
NHS Cervical Screening Programme (NHSCSP) • Introduced in 1988 • Current programme • 25-49 years – 3 yearly recall • 50-64 years – 5 yearly recall (ending when most recent result negative, with normal recall and next date falls after 65th birthday) • Uptake rates • 1989 – 40% • 2008/9 – 79.8% - ‘Jade Goody’ effect – extra 400,000 tests • Currently at its lowest rate for 20 years!
Why are women not attending? Almost 3.7 million women missed their screening appointment in the last 5 years – this is 1 in 4 women. WHY?
Why are women not attending? • Knowledge about the test • Fear of the test • Access to Appointments
Knowledge about the test • Unaware of screening programme • Women from ethnic minority groups • Women with learning disabilities • Not recognising they are at risk • Older single/divorced women • Understanding the role of HPV (human papillomavirus) • HPV Primary Screening • Unaware of symptoms of concern • Abnormal bleeding/discharge, pain on intercourse
Fear of the test • Younger women not knowing what to expect • Social media, horror stories • Previous experience • Fear of the result • HPV positive result – ‘have I got an STI?’ • Pain following the menopause • Vaginal atrophy
Access to appointments • Difficulty getting appointment at surgery • Inconvenient times, cancellation • Lack of employment flexibility to attend • Day time appointments, nurse running late • Other responsibilities eg childcare • No female sample takers • Particularly ethnic minority groups
What are we doing at Angel Hill? • All new women registering are contacted by practice nurse • Monthly review of non-attending women with a letter inviting them • Text reminders of appointments • Variable appointment times with nurses • Jo’s Trust Posters in all waiting areas • Where possible, screening done opportunistically • Educated practice nurses • Women’s Health Specialist GP – Me!