Monday 26 September 2016

Revealed: The biggest influence on a woman's decision to have a smear test

Published 21/06/2016 | 10:19

(Stock photo)
(Stock photo)

GPs have the biggest impact on a woman's decision to have regular cervical screening, according to a study.

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Currently over 4,500 doctors and nurses in GP practices, women's health, family planning and Well Woman clinics are registered to provide the free screening through Cervicalcheck.

However, a study, led by the National Cancer Registry, found GPs have the crucial role in influencing women to have a test and making them acceptable.

“Women were predominantly very trusting of their GP and the information provided by them,” said the study, spearheaded by Mairead O'Connor.

Motivators to attend, according to focus groups involved in the study, included advice that screening can be life-saving.

A positive attitude by their GP to screening strongly influenced their likelihood of attending for a test.

It was suggested that doctors could bring up the issue while having a consultation with the patient about another health matter.

Cervical screening is not a test for cancer but a check on the health of the cells of the cervix.

Most women's test results will show that everything is normal, but for around 1 in 20 women the test shows some abnormal changes in the cells of the cervix.

However, most of these changes won't lead to cervical cancer and the cells can return to normal without intervention.

In some cases, the abnormal cells need to be removed so they cannot progress to cancer.

Fall-off

The Dublin Well Woman Centre in its most recent annual report noted a fall-off in the numbers of women attending for screening under the free Cervicalcheck programme.

The greatest reduction in numbers attending for smear test is in the 25 – 29 age group.

“In 2006 some patients would have requested tests more frequently than the three year interval set by the Cervicalcheck screening programme.

“Due to emigration there may simply be less women in this age group to attend for screening,” it said.

The clinic also said another aspect of note is the reduction in older women attending for testing.

“Initially the smear programme did seem to increase the numbers of middle aged women getting tested but this appears to have levelled off. The average age for diagnosis of cervical cancer is 44 so it is important that this age group is seen.”

It recently emerged that the incidence of cervical cancer in poorer areas the country was 120pc higher than in better off regions between 2008 and 2012.

Over 300,000 women were screened under the national screening programme Cervicalcheck between 2013 to 2014.

Around 77pc of eligible women availed of the service from the point at which it was set up in 2009 to 2014.

However, it means that nearly one third were not screened.

Changes

Meanwhile, a major assessment report is due later this year from the patient safety watchdog, the Health Information and Quality Authority (Hiqa) which is conducting research to determine if the method of cervical screening should be changed.

The health technology assessment is independently evaluating the clinical, financial, ethical and organisational implications of establishing human papillomavirus (HPV) testing as the primary screening test for preventing cervical cancer.

At present, liquid-based cytology is used as the primary screening tool by CervicalCheck.

If low grade abnormalities are detected, the same sample is tested for HPV DNA to determine if the woman should be referred for further tests or back to routine screening.

Changing the order of these tests - using HPV DNA testing as the primary test followed by liquid-based cytology- has the potential to improve the detection of cancerous and pre-cancerous cell changes and to increase the efficiency of the screening process.

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