Watching Lynsey Bennett on The Late Late Show, it was difficult to accept this vibrant, positive, young woman could be seriously ill. It’s an incongruity sure to have prompted many women to think about cervical screening.
Lynsey’s story is heartbreaking because she was one of the very unlucky few for whom screening does not pick up their cancer: there is a small number of false negatives also with breast- and colon-cancer screening.
How many of us in a similar position could overcome our pain and anger to encourage others to avail of a process that, tragically, did not work for ourselves?
When Jade Goody was diagnosed in 2008, this led to an increase in cervical screening coverage in the UK.
And similarly Lynsey’s willingness to put herself forward will most likely end up saving lives here. Her heroism should be capitalised upon and the HSE should take this opportunity to seriously think about how it can better reach those women currently not attending.
In 2017 the figures showed 79pc of the eligible 1.2 million women had gone for screening. You can view this as a good news story because the result is CervicalCheck refers 6,500 women onwards each year for treatment who do not go on to get cervical cancer. Or you could frame it as more than one in five women are not attending, so how can we increase that?
Speaking at a joint Oireachtas committee in December, Dr Nóirín Russell, clinical director of CervicalCheck, pointed out there had been a culture in CervicalCheck that women had received their first invitation letter and waited for the first and second reminder; she wanted to urge women to attend on their first invitation.
To improve the numbers getting checked, the reasons for the above reluctance need to be explored.
Behavioural economics is a way of looking at why people don’t make decisions that would be best for them but actually you don’t need to probe too far to see why women don’t attend cervical screening.
Getting the entrance to your womb examined through the vagina is an uncomfortable process – it’s not that it is unbearably sore, it is a little sore, but it is not a pleasant experience.
Having said that, every single time, in my experience, the dread is much worse than the event and the people involved are always so lovely. But you can see why you might put it off – especially if you have bigger worries on your plate.
I once ignored my invitation to make a screening appointment after an unfortunate experience with a gynae six weeks after childbirth who unsuccessfully spent 20 minutes hunting for my cervix to insert a coil. Luckily, when I went for screening a year later it had snapped back into place but you can see why I dodged the screening for so long.
What would have nudged me along? Well, in my case I never got the letter inviting me to make an appointment because I had moved house, but even if I had got it, I probably would have tucked it away in a drawer. I suspect a series of cheerful but firm text messages and emails arriving each week informing me it would ‘only take two minutes and it is not so bad – just do it’ might have worked.
Is it time we moved to an electronic system as a back-up to the letters?
You don’t need a letter to make an appointment, you can just log on and see if you are due, but it is human nature to not rush into things we don’t want to do and this should be anticipated.
The HSE must have learned relevant lessons from Covid testing and contract tracing in how best to communicate with people? The texting worked well once the glitches were ironed out.
CervicalCheck has got good news to communicate and on an electronic system it could do this more loudly.
There are obviously improvements needed such as more funding for GPs and primary care specialists, for access to gynaecology clinics, but our screening programme does very well based on international figures and has led to a consistent reduction in cervical cancer numbers since it was introduced in 2006.
Given all the negative publicity around screening it’s important to get that message out so women don’t decide it’s not worth it.
A new way of screening was introduced in March 2020 which was bad timing for getting any health promotion messages out. The new HPV screening first looks to see if a person has any of the high-risk types of human papillomavirus (HPV) that may cause cervical cancer (70pc are caused by just two types out of 100).
It is a better way of screening and €2m in funding has been already allocated this year for extra colposcopy services; it prevents more cancers and means some people will only go for tests every five years instead of three – very welcome news.
The causes of many cancers are mysterious, and therefore unavoidable, but this is not the case with cervical cancer.
Today in Ireland we still lose 90 women every year to the disease – that is a lot of lives lost and families left devastated – so there is a lot more we can do.
It is admirable of Lynsey Bennett to speak so openly because her story will encourage more women to go for screening – she will no doubt reduce the numbers that die each year.
Her generosity is mindblowing.
In turn, the HSE must maintain the momentum her bravery will no doubt spark and introduce improved communication techniques to ensure everyone who is eligible for screening does go along.