What did you do when you received your invite for cervical screening?
‘The low uptake of cervical screening in the Black community, is killing some of us!’.
Dear sistas,
It appears we are having a pandemic of our own and I want us all to know more about this and understand why we need to educate ourselves and others.
So here we go...when did you last have a smear test?
For some of you the answer to this question will be never, for some of you it may be as per the screening programme and for others, one bad experience and you were done. Well, I am here to tell you that all of us at some point could be in one of those positions, but let’s remove the first and last options from our futures.
The aim of this article is to raise awareness and facilitate an open discussion about ‘why we need to add cervical screening to our self-care portfolio!’.
Annual statistics from the NHS Screening Programme reveal the age and location of non-attendees, but they do not keep tabs on ethnicity. That said, there are claims that black women are less likely to take part either partially or fully in the cervical screening programme and more likely to die from preventable and treatable cervical cancers.
Let me tell you more about cervical screening:
What is a smear test?
Cervical screenings (a smear test) are a preventative measure that are used to detect any abnormal cells in the cervix. The cervix is the opening to your womb from your vagina and smear tests are health checks for your cervix. Smear tests are not a test for cancer, they are a test to help prevent cancer.
Who should have a smear test and why?
‘Cervical cancer is the most common cause of cancer in women under 35, with around 3,000 new cases being diagnosed every year. Research shows that 75% of all cervical cancers are prevented from developing due to early detection of abnormal cells and treatment’.
In the UK all women 25 -64 (or after having a child) should attend screenings every three years so that cell changes can be monitored. Cervical screening can save your life.
What are they looking for?
The sample is checked for certain types of human papillomavirus (HPV) that can cause changes to the cells of your cervix. These are called “high risk” types of HPV. If these types of HPV are not found, you do not need any further tests.
If these types of HPV are found, the sample is then checked for any changes in the cells of your cervix. These can then be treated before they get a chance to turn into cervical cancer.
When in my menstrual cycle is the best time to have a smear test?
Usually, 7 or more days after your last menstrual period is the optimum time to have a smear test done. This reduces the chances of having blood in the sample, making the test void and the procedure requiring a repeat.
What does the smear test procedure involve?
You will receive an invite in the post from the National Screening Department telling you to book a test. With this invite there will be the most current information for you to read.
You book an appointment (usually at you GP/local clinic) for the smear test and attend on the day.
The healthcare professional will go through a series of questions with you, including your information about your sexual history. This for some maybe an uncomfortable discussion but its not about judgement it’s about making sure you are having the right test/s carried out and the sample is examined in the best possible way for your health.
Following the discussion and completion of paperwork you will be offered the smear test.
The procedure is usually quick, taking 5-10 minutes and can be uncomfortable both physically and emotionally but please, don’t let your feelings deter you, instead talk to the nurse or doctor prior to and during the procedure, to make sure you can be as relaxed as possible.
The procedure requires you remove your lower clothing and lie flat on a couch/bed with usually a large piece of paper roll or sheet covering your lower abdomen and genital area. You will be asked to put the soles of your feet together and relax your legs to be in the correct position. Some women may also be asked to make fists with both of their hands and place them under their bottom to tilt the cervix forward, making it accessible for the procedure. A speculum (a metal instrument that is used to dilate the cervix, to allow inspection) and small brush are inserted into the vagina to remove a sample of cells from the neck of the cervix.
What can I expect after the procedure?
Some women can be uncomfortable for a short time and may experience some light bleeding.
When will I get the results?
If you have your sample taken with the NHS, results are usually returned within two weeks, though this varies from location. Outside of the NHS, please discuss how and when you will receive your results, with your provider.
In most cases, results will be normal, and this will mean you continue the 3 yearly cycle of national cervical screening programme. For a small number of women, the results of the smear test will be abnormal, and they will be asked to return for further testing and/or treatment.
Now you know what happens when and why, lets address why for many for us this isn’t the case.
Firstly, be careful about what you read:
‘To understand the barriers to screening for BAME women the charity commissioned research with YouGov that looked into cervical screening uptake and knowledge about cervical cancer within BAME communities and comparing this to responses from white British women.’
This survey found:
‘BAME women were more likely than white women to say they had never attended a screening (12% vs 8%)’
But what it does not tell you is this survey of almost 2,000 women only involved 225 BAME women vs 1,752 white. This was a charity commissioned piece of research funded to understand the barriers to screening for BAME women and less than 13% of the participants were from a BAME background!
The survey also found: ‘Twice as many BAME women as white women said better knowledge about the test and why it is important would encourage them to attend (30% against 14%)’
This is significant for us to know, despite the small numbers of BAME participants over double of those that took part compared to their white counterparts needed a better understanding, and that’s why this piece has been written for you. Knowledge is empowering.
1 in 4 women who are invited for screening do not attend and there is evidence that this is most often due to embarrassment. Ladies please do not let the size, shape, colours, or smell of your vaginas stop you from protecting your health. We are all different, that’s what makes us unique, if you have a particular concern about your vagina seek medical advice, even ask the person carrying out you smear test!
Culture and religion, alongside language barriers have also been raised as barriers to black women attending cervical screening. Although cervical screening is not the most pleasant of experiences it is one, we all need to talk about more. Seeking female only healthcare professionals and increasing modesty within the appointment can all be achieved with an open dialogue and forward planning with your healthcare provider. Never assume you are the only one who needs more from the service. Instead, believe everything you achieve for yourself is likely to pave the way for another black woman hashtag….
Where can I complain or compliment the service?
Unfortunately, bad experiences in the NHS are real. The Cervical screening service is no different. Firstly, if the healthcare professional you meet has not made you feel comfortable by being kind caring and compassionate you may choose to re-book your smear test. It is a procedure that requires you to be relaxed, if this is not achievable the whole process will be made worse, trauma of any kind is not something any woman should choose.
Equally if the procedure is ongoing and you are feeling more than discomfort you can say stop. It is your body, your smear, you can re-book.
If, however you decide to go ahead with the procedure and feel your treatment was less than you expected ask to speak to the practice manager. Explain your concerns and put your complaint in writing that they will have to reply to following investigation.
Not got the answers you want contacts below:
Public Health England Screening HELPDESK- 020 3682 0890 or email - phe.screeninghelpdesk@nhs.net.
Jo’s cervical cancer trust - 0808 802 8000
Send us your experiences on the Forum and follow us @Onyxyayas on Instagram and Pinterest
Want to research cervical screening further, here are some places to start:
https://www.theguardian.com/society/2020/aug/25/cervical-cancer-bame-women-more-likely-to-miss-screenings-amid-pandemic
https://www.nhs.uk/conditions/cervical-screening/
https://researchonline.lshtm.ac.uk/id/eprint/2534172/