New challenges to attendance in the wake of the COVID-19 pandemic.

Cervical cancer is the only one of the five gynaecological cancers to have an effective screening programme. It is currently offered to all women and people with a cervix age 25 to 64. It is offered every 3 years for those aged 26 to 49, and every 5 years from the ages of 50 to 64.

It is estimated around 5 million women and people with a cervix are invited for cervical screening every year in the UK, but over the last few months many tests have been postponed and invitations to attend paused during the COVID-19 pandemic.

Led by Jo's Cervical Cancer Trust, the UK's leading cervical cancer charity, this annual Week aims to raise awareness of cervical cancer and stress the importance of screening. In addition, this year, the Trust provides useful information to help navigate changes to the cervical screening programme as a result of coronavirus.

What is cervical screening?

The cervical screening test ("smear test") is not designed to detect cervical cancer, but to test for high-risk human papillomavirus (HPV). High-risk HPV can cause cervical cell changes to develop into cervical cancer. If high-risk HPV is detected, the sample will be looked at for abnormalities. If there are no abnormalities that person will be invited back for screening in 1 year. If abnormal cells are found, normally that person is invited to attend a colposcopy procedure at the hospital, to further investigate.

The NHS has set out useful guidance about the screening process https://www.nhs.uk/conditions/cervical-screening/ and colposcopy procedures https://www.nhs.uk/conditions/colposcopy/.

Screening and COVID-19

The NHS cervical screening programme and coloscopy referral process never stopped in England, although invitations were paused from 9 April 2020. Whilst some screenings did go ahead many appointments were delayed or cancelled. In response to NHS England's letter on 29 April advising NHS regional public health commissioning teams to "step-up" non COVID-19 urgent services, from 6 June 2020 invitations to attend screening have been rolled out again. Many GP surgeries across England are beginning to resume cervical screening, although this is dependent on their capacity.

Research from Jo's Cervical Cancer Trust which coincides with the Awareness Week found while 40% of women would feel relieved to be able to go to a cervical screening, around one in eight women (12%) say they feel less likely to attend than before the COVID-19 pandemic and 13% think it is best to put off going for cervical screening at the moment.

To support continued attendance the Trust launched FAQs to address common concerns; from what to expect at an appointment to whether it is advised to go if you are isolating or shielding. For those who would like further information or support, the Trust's National Helpline is free and confidential on 0808 802 8000.

The overwhelming message of the Week is that the screening will be exactly the same, but just with safety measures in place.

Originally published by Anthony Gold, June 2020

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