Somewhere in the world, a woman dies every 2 minutes from a totally preventable illness. Cervical cancer takes the lives of 900 women in England alone each year. It is the biggest killer of women aged under 35 years.
The national vaccination program targeting 12-13 year old girls which started in 2008, has made a huge difference to the rates of young women contracting HPV, the virus responsible for cervical cancer.
It is now estimated that the vaccination together with cervical smear screening may eliminate the disease altogether within the next two decades.
From September 2019 12-13 year old boys will also be offered HPV vaccine at school. The vaccine will not only help protect men from spreading HPV among the female population, but it will also protect them from cancer of the penis, anus and head and neck (oral sex with someone who has the virus can cause head and neck cancer in men and women). This is a welcome move by campaign groups and health care providers across the UK.
However, there are some groups who continue to be vulnerable. Those women who were not vaccinated at school, either because it was not available to them when they were at school (mainly women born before 1991), or because they declined to take up the offer at the time. It is essential that these women still attend for regular cervical smear tests.
There is also a marked drop in attendance rates for routine cervical smears for women in the 50-64 age group. The reason for this is not fully understood but it may relate to the fact that women consider themselves to be low risk after their child-bearing years. However, new cases of cervical cancer diagnosis account for only 4% of women in this age group but make up a staggering 24% of death from cervical cancer. This underlines how important it is that these women must take part in the national screening programme.
Women from ethnic communities are also particularly hard to reach according to publications such as BMC Women’s Health. In a study recently published, it showed that perceived low risk may be one of the factors which deters women from these communities from attending. However, as the incidence in cervical smear cases starts to reduce due to vaccination and regular cervical smear tests in the population as a whole, the relative incidence of cancer will increase in ethnic groups until herd immunity can reduce the incidence of cancer overall. However, this may take up to 20 years to happen and until it does, regular screening will save lives.
Lastly, women over 65 are not currently offered routine cervical smear tests. It is thought that this age group does not need to be tested provided that women have had no abnormal smear result during the past 10 years. However, records show that this group has the fastest growing rates of cervical cancer accounting for around 20% of new cases each year. Women are living longer and remaining sexually active later into their lives making them a group to watch out for.
Perhaps 65 is no longer a safe cut-off point?
In the meantime, the message to women needs to continue loud and clear – cervical screening saves lives and regular cervical cancer screening every three years as a minimum is still essential.
Contact your GP or local screening facility for more details.
Shelia Harrington – @sharrington_k