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Lee Goodare considers cancer screening

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VOL: 98, ISSUE: 24, PAGE NO: 31

Lee Goodare is assistant clinical editor, Nursing Times

With the Advisory Committee on Cervical Screening meeting next week, we present a detailed examination of the NHS Cervical Screening Programme. In the 14 years since it was set up there has been a consistent reduction in the mortality rate from cervical cancer, but debate on the service continues.
With the Advisory Committee on Cervical Screening meeting next week, we present a detailed examination of the NHS Cervical Screening Programme. In the 14 years since it was set up there has been a consistent reduction in the mortality rate from cervical cancer, but debate on the service continues.


Shaw's article includes a discussion of the fact that the frequency of screening depends entirely on a woman's geographical location. Current guidelines from the Department of Health state that all women aged between 20 and 64 are eligible for screening and that this should take place 'every 3-5 years.' It is then up to individual health authorities to decide on the recall period.


Currently, about 70% of authorities screen women every three years and the rest screen every five years. This is not an equitable service.


Media attention has often focused on the negative and controversial aspects of screening. But it is essential to remember that the current programme saves about 1,300 lives a year (Sasieni and Adams, 1999). Also, the proportion of inadequate cervical smear tests has fallen for the first time in 10 years.


Attending for regular smear tests is still the best defence against cervical cancer. But even an improving system will not work without uptake and recent figures reveal a drop in attendance in all age groups across the country (NHS Cancer Screening Programmes, 2002).


A recent survey by the Office for National Statistics, supported by the NHS Cervical Screening Programme, found that the reasons for non-attendance included embarrassment, concerns about the lack of privacy and fears about the test causing pain. Some respondents even believed that they would benefit from screening only if they already had symptoms.


Nurses can help to allay these concerns and provide support for women, particularly those in deprived areas and minority ethnic groups. Good communication cannot solve everything, but it can positively influence the take-up of services, and contribute to the crucial early detection of the disease.
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