WITH the Brexit debacle continuing to dominate, it’s certainly been a good week/month/year to bury bad news. The other side of that coin, of course, is that some positive stories haven’t had the attention they deserve.
Chief among them over the last few days was an update on one of the most remarkable medical success stories of our times. The HPV vaccine was introduced in Scotland a decade ago in an attempt to combat the human papillomavirus (HPV), a sexually transmitted infection that is the primary cause of the vast majority of cervical cancer cases.
You will remember that Scotland was at the forefront of administering the vaccine to girls aged 12 and 13, and researchers found it has resulted in a 90 per cent drop in cervical disease, almost wiping out cases of pre-cancer for this vaccinated generation, totally exceeding the expectations of those who launched the programme.
READ MORE: School HPV vaccine delivering 'dramatic' cuts in cervical disease, finds study
What extraordinary and wonderful progress in such a short time, meaning far, far fewer of our daughters, granddaughters and nieces will contract and die of cervical cancer. Indeed, we can even foresee a time in the not too distant future when this terrible disease, which currently kills two women in the UK each day, could be eradicated altogether.
Future generations of women will also be spared the stress and worry of receiving the letter to say a recent cervical smear test has revealed abnormal, potentially nasty cells. I’ve had that letter multiple times and undergone the follow-up examinations and treatments; thanks to the treatment and monitoring of NHS staff, I’ve been cured of these pre-cancerous cells and been fortunate enough to go on my way.
Many other women haven’t been so lucky, of course. And rising numbers aren’t even getting themselves checked out. So, as we celebrate the success of the HPV vaccine we must also face up to some very worrying trends around those too old to benefit from it.
The incidence of cervical cancer has risen rapidly in Scotland – by 22 per cent – over the last decade, fuelled by the fact that fewer women are going for routine screening. One in four women ignore their invitation for a smear, with the miss rate even higher – some 37 per cent – among young women aged 25-29.
The Greater Glasgow area has the highest rate of non-attendance and uptake is particularly low in deprived areas. Women from ethnic minorities are also less likely to be tested.
When you dig deeper into the reasons young women aren’t going for smears it makes for particularly grim reading. Data from charity Jo’s Cervical Cancer Trust shows many miss tests saying they can’t fit an appointment into their busy lifestyle or don’t seem aware of how important getting tested is. Others report being too embarrassed, citing body shape and unhappiness with the appearance of their vulva, with a third telling researchers they wouldn’t get a test if they hadn’t waxed or shaved their bikini area.
Speaking to younger friends, family and colleagues, I’ve also noticed an increasingly widespread and worrying belief that smear tests are painful and/or humiliating. I even read a hysterical piece in a national newspaper recently claiming the majority of women find the test excruciating. The article also contained a bizarre undercurrent that seemed to suggest the speculum was a misogynistic instrument of torture created specifically to inflict pain upon women. The piece also suggested most NHS staff carrying out smear tests were of the Nurse Ratched variety - stern and uncaring.
We badly need to change this type of narrative before it scares any more young women off.
I fully understand that for some, smear tests are painful. But to suggest that this is the norm is both wrong and dangerous. For most the test is over in a minute or two and rarely as bad as you think it will be. There are many routine medical tests that are far more unpleasant, intimate and painful.
At the same time, we must encourage more nervous women to be open about their fears, so they can be overcome. Nurses really have seen it all before and are adept at putting women at their ease and advising on relaxation techniques such as breathing exercises. Many women may not be aware that you can ask for a smaller speculum. You could also take a friend with you.
Something is clearly very wrong when a growing number women are risking dying of embarrassment and misinformation, despite the fact society is more open than ever before. It’s all the more frustrating when you consider that cervical cancer is one of the few that is genuinely preventable.
In future, women probably won’t have to have smear tests at all. Cervical cancer will have been all but eradicated and any remaining testing will perhaps be done through blood and urine tests.
Until that day, women should be thankful for the simple, effective smear test. Yes, health officials should try to find ways to encourage us to take it. Ultimately, though, it’s in our hands. We have the power to prevent cervical cancer. Please, please use it.
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