FIONA'S LAW - Women should be allowed a yearly Cervical screening

Cervical screening needs to be every year.

This is because women are dying, mothers, wives, daughters, granddaughters and sisters are dying.

We need yearly checks regardless of the statistics.

It should be law that every women in England can access a yearly smear test.

So they have a future.

You are preventing women from watching their children grow.

My friend will never see her children's first day at school, watch her children grow, fall in love, watch them get married or hold her grandchildren.

This could have been prevented.

We are so sorry for your loss of your friend but want to assure you that the Government is committed to the prevention and early detection of cancer, so that the lives of many more women can be saved.

Cervical screening is vital in the early detection of cervical abnormalities that could cause cancer. The NHS cervical screening programme reaches approximately 7 million people and saves an estimated 5,000 lives per year, and is a key part of the Government’s commitment in the NHS Long Term Plan to detect 75% of cancers at stage 1 or 2, and for 55,000 more people to survive cancer for five years in England each year from 2028.

The NHS cervical screening programme currently invites women between the ages of 25-49 for a routine screening appointment once every three years, those between 50-64 years old every five years, and those 65 and older only if one of their last three tests detected abnormalities. However, it is important that anyone at any time and of any age who is worried about cervical cancer, or who notices any unusual symptoms, should not wait for a routine screening appointment and should see their GP as soon as possible.

NHS screening programmes and policy are based on the expert advice of the United Kingdom National Screening Committee (UK NSC). Using research evidence, pilot programmes and economic evaluation, the UN NSC continually assesses the evidence for programmes and the way in which they are delivered against a set of internationally recognised criteria.

In 2015, the UK NSC recommended changes to the NHS cervical screening programme that have made it more effective and require women to be screened less frequently. Since then cervical screening has been a two stage process. All screened women are now tested for certain types of human papillomavirus (HPV). The HPV test can predict whether a woman may develop cervical cancer: this is because HPV can cause cells in the cervix to become abnormal, and potentially become cancerous.

If HPV is detected as part of routine screening, a cytology test to check for any abnormal cells is then used in a second stage of screening. If no abnormal cells are found, a follow up screening appointment is arranged 12 months later to see if the immune system has cleared the virus.

If, however, a woman does not have any evidence of HPV infection during routine screening, her chances of developing a cancer within five years are very small. As nearly all (99.7%) cervical cancer is caused by HPV, a HPV-negative result indicates that there is no requirement for further tests. It would be highly unlikely in these circumstances that there would be any abnormal cells, and even if there were, it would be extremely unlikely that they would cause any problems since research suggests that at least ten years elapses between acquiring HPV and developing cancer. You can read more about the UK NSC’s research and recommendations here: https://legacyscreening.phe.org.uk/cervicalcancer, https://webarchive.nationalarchives.gov.uk/20150401104305/

On the basis of this rigorous two stage process, the high negative predictive value of HPV testing and the low false negative rate, the UK NSC does not recommend that women be tested every year.

We acknowledge however that screening is not perfect and will not detect all cases. For cervical screening, this can happen if the HPV infection or abnormal cells are missed, or because abnormal cells develop and turn into cancer in between screening tests. Occurrence is rare, and we are sorry that this happened in Fiona’s case.

It is important that as many women as possible attend screening and are aware of the symptoms of cervical cancer. Public Health England is working continuously to raise awareness of cervical cancer through the national ‘Be Clear on Cancer’ campaigns, which have been run in partnership with Cancer Research UK since 2011. A specific awareness campaign, ‘Cervical Screening Saves Lives’, was held in 2019 and is currently being evaluated.

The incidence of cervical cancer can also be reduced by reducing the incidence of HPV infection circulating in the population through vaccination. Since 2008, girls aged 12-13 years old have been offered a first dose in school year 8. From September 2019, boys in year 8 have also been offered the HPV vaccine to further decrease the circulation of HPV. The vaccine has led to a dramatic reduction in HPV infection in young women in England, and will reduce their future risk of cervical cancer. A sustained programme of HPV vaccination is eventually expected to save over 300 lives a year (https://www.gov.uk/government/news/hpv-vaccine-could-prevent-over-100-000-cancers).

Due to the high accuracy and predictive value of the HPV screening test, the UK NSC has not recommended that women are screened on a yearly basis. Cases such as Fiona’s, while extremely tragic, are rare. The most effective way to prevent deaths from cervical cancer is for as many women as possible to attend their routine appointments.

Department of Health and Social Care