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Survey: Over two thirds of young women wouldn't tell a nurse their smear test worries

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Over two thirds of young women would not tell a nurse about their smear test worries, suggests a new survey that raises wider concerns around uptake of screening for cervical cancer.

The survey by Jo’s Cervical Cancer Trust has uncovered a wide range of new issues surrounding smear tests, which it fears are contributing to the decline of women attending the test.

“It’s really worrying that so many women wouldn’t share their concerns with their nurse”

Mariane Wood

The charity surveyed 2,005 25-35 year olds in December last year, in a bid to find out what was putting young women off having a screening.

According to the charity, the number of women attending cervical screening is plummeting and is as low as one in two among young women in some areas of the UK.

It said it understood that many people were scared or embarrassed about attending, but also noted that “worryingly” its new research had revealed 68% of young women would not tell their nurse about their smear test worries.

Feelings of vulnerability and not being in control was high among the respondents, as 28% reported they would feel uncomfortable about asking a nurse to stop during a smear test, while 18% said they would feel uncomfortable asking what the nurse is doing during the test.

“This way we can raise awareness of the barriers and issues preventing attendance”

Kate Sanger

In addition, it found that 19% of the full sample would not raise their worries as they do not think the nurse would be able to do anything about it anyway. The charity said it wants women to feel comfortable in talking to their nurse and be able to ask questions.

Marianne Wood, colposcopy nurse at St George’s Hospital, London told Nursing Times: “It’s really worrying that so many women wouldn’t share their concerns with their nurse, especially as there are lots of things we can do to make the test easier or more comfortable for their women who are worried.”

“Making time for the patient before the test so that they can ask any questions they have often really helps, as does explaining what’s going to happen,” she said.

Ms Wood highlighted the importance of nurses, who carry out smear tests, to show “empathy and understanding” to their patients.

She said: “There are lots of reasons that someone might find a smear test difficult – we need to be aware of these reasons, as well as what we can do to reverse the trend of falling attendance.”

The research carried out by Jo’s Cervical Cancer Trust also highlighted that 71% of young women who delay or do not go for a smear test feel scared at the thought of going, while 75% reported they feel vulnerable at the thought.

The charity also found 81% of those surveyed to feel embarrassed and 67% said they would not feel in control at the prospect of a test.

“We want women to feel comfortable talking to their nurse and asking questions”

Robert Music

Almost half of the young women who took part in the research admitted they regularly delay or do not take up their invitation, the charity added.

Meanwhile, worries about making a fuss stood at 27%, fear of being judged at 18% and thinking their concerns are too silly or small at 16%. The charity noted that, as a result of these worries, women may be avoiding a potentially life-saving test.

When asked what has caused them to delay or miss a test, the survey found three quarters (72%) reporting that it was due to embarrassment and 69% reporting that it was because of the thought of a stranger examining an intimate area.

The charity stated that 58% of respondents had fears that the test would hurt and 44% said not knowing how to talk to a stranger about intimate body parts would also put them off having the test.

A sense of not knowing what will happen during the test (37%) was also given as a reason by those who were surveyed.

Kate Sanger, from Jo’s Cervical Cancer Trust, told Nursing Times: “Young women are the least likely demographic to attend screening, so we wanted to understand the reasons and what was putting them off.

“This way we can raise awareness of the barriers and issues preventing attendance, as well as provide information and support for both patients and healthcare professionals,” she added.

Jo's Cancer Trust

‘Unmet need’ for aftercare in women with cervical cancer

Robert Music

Robert Music, chief executive at the charity, said: “Smear tests provide the best protection against cervical cancer, yet we know they aren’t always easy.

“We want women to feel comfortable talking to their nurse and asking questions,” he said. “It’s not making a fuss and there are many ways to make the test easier. Please don’t let your fears stop you booking a test.” 

Mr Music added: “Our research has again highlighted the urgent need for making the programme more patient-focused.”

He explained that the charity wanted to see “self-sampling” being made more available and more “flexible locations” for women to attend.

“It’s vital women have more control otherwise we will see attendance continue to fall and diagnoses of this often-preventable cancer increase,” he said.

The charity is launching its #SmearForSmear campaign during Cervical Cancer Prevention Week today to tackle the decline and acknowledge the fact that going for a smear test can be difficult. Through the campaign it wants to highlight the support available to women as well as tips to make the test better.

Further survey findings include:

  • High numbers of women who attend regular tests still feel body conscious (67%), scared (43%), vulnerable (46%) and not in control (36%) before their test
  • When asked about their biggest worries, those who delay or don’t attend said a stranger examining an intimate area (57% vs 40% who always attend), general embarrassment (54% v 35%) and fear it will hurt (44% vs 36%)
  • While smear tests are the best protection against cervical cancer, fear of the disease is worryingly high among those who don’t attend or delay (40%)
  • Fear of cancer appears to motivate those who always go, cited by 60% as one of their biggest worries
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