Breaking Down the Stigma: Why We Need to Keep Talking About Smear Tests
Recently there has been a much-needed reinvigoration of the debate about lowering the age at which women in the UK are invited for a cervical screening test - more widely known as a smear test. Women are currently only invited to attend a cervical screening once they reach age 25, but there is a rapidly growing argument in favour of lowering the age to 18.
According to the NHS, the reason that the smear test is currently only offered to women aged 25 and over is due to the fact that cervical cancer is most common amongst women aged 30 to 45, with cases of cervical cancer in women under 25 being much rarer.
However, there are young women who have developed cervical cancer much earlier in their life, many of whom are now vocal members of the movement to have the age lowered, in order to protect other young women at risk. Abigail Howes is just one example of a young woman who has shared her story of developing cervical cancer at just 22 years old, after being denied a smear test due to her age, despite showing worrying symptoms such as abnormal bleeding. She, along with many other young women who have been diagnosed with cervical cancer, are advocating for the age to be lowered so that girls are not spending years undiagnosed before they turn 25, when they could be tested while it is still preventable or at an early stage.
Since cervical cancer becomes possible as soon as women become sexually active, which in a lot of cases will be before they turn 25, there is a strong case for lowering the age to 18. By starting the routine checks from an earlier age, and closer to the point at which women first become sexually active, any potentially cancer-causing changes in the cervix cells can be identified and promptly treated.
Last year, an online petition was started by Natasha Sale, who after being diagnosed with metastatic cervical cancer herself, became dedicated to having the age of invitation for a test lowered from 25 to 18, in an attempt to potentially save other women from the ordeal she has gone through, before it’s too late for them.
The petition reached well over the 100,000 signatures needed to take it to Parliament and so the issue is to be debated by MPs on Monday the 28th of January.
The cervical screening or ‘smear’ test is a method for detecting pre-cancerous changes in the cervix, which once detected, can be addressed before they develop into cancer. It’s done by using a speculum to slightly open up the walls of the vagina, just enough to see the cervix and take a quick swab of the cervix cells. These cells are then tested for any abnormalities.
Changes in the cervix cells are nearly always caused by the human papilloma virus, of which there are up to 100 different types, with only some of those being at high risk of causing cancer.
It’s extremely important for women to routinely attend their cervical screening appointment so that any potential changes to the cells can be detected before they become dangerous. Since its introduction in the 1980s, the smear test has successfully reduced the number of cervical cancer cases by about 7% each year, according to the NHS.
The procedure is a fairly quick and straight forward one, yet there is evidently a problem with women not attending or delaying attending their screening because they have anxieties about the test itself. A recent study by Jo’s Cervical Cancer Trust worryingly suggests that as many as one third of young women delay or don’t attend smear tests. This may be because women feel embarrassment about their body shape or their smell or because they have anxiety over the thought of having their intimate area inspected by a stranger.
However, there is a fast-growing campaign at the moment to break the fear around smear tests, with activists and doctors emphasising how a simple two-minute procedure has the potential to be lifesaving. With the introduction of a new type of speculum – made out of plastic rather than the older model, which was made out of cold metal – the process has become even easier than before.
Though there is obviously an element of discomfort in the process, that discomfort is minor in comparison to the treatments you would undergo if you let potentially cancerous cervical changes go unnoticed. Many women have suggested that if you can tolerate sex, you will be able to tolerate the mild discomfort of cervical screening.
To deny women the right to be checked because of their age, despite being at risk of developing cancer, and especially for those who have had visible symptoms yet are still denied a cervical screening, is unfair and unacceptable. Even the few examples of young women that have come forward and spoken out about their experience of being denied a smear test because of their age, and then subsequently diagnosed with cervical cancer before turning 25, should be enough of a motivation to have the age lowered already.
Recognising that a majority of women will become sexually active before 25 and so are at risk of cervical cancer will be the first step to lowering the age of invitation. As soon as the risk is there, women deserve to be invited for a smear test, especially if they themselves ask to be tested, and are showing symptoms. Alongside lowering the age, there ought to be a conscious effort to destigmatise the smear test from being perceived as something that is uncomfortable and something to fear, instead being seen as a necessary check-up that could prevent cancer. Doing so could prevent more young women from becoming one of the 3000 cases of cervical cancer diagnosed every year in the UK.