BMJ: Cancer screening uptake- only a third of women take up offers

Torjesen, I. | 2019| Cancer screening: only a third of women in England take up all offers | BMJ| 366 | l5588 | doi: https://doi.org/10.1136/bmj.l5588

A new study published in the BMJ indicates that of the screening services offered to women in their 60s, which include cervical, breast and bowel screening only a third attend these screening sessions.  

The study included over 3000 women aged between 60-65 who had responded to their last invitations from each of these three screening programmes.

Results showed that:

  • 35% took part in all three screening programmes;
  • 37% participated in two programmes;
  • 17% accessed one type of screening; and
  • 10% were not screened at all.

They found that in the last screening round, 2525 (83%) had taken up mammography, 1908 (62%) cervical screening, and 1635 (53%) bowel cancer screening, which is consistent with the proportions reported in the official statistics for England (78%, 58-59%, and 57-59%, respectively).

The researchers also explored area level correlations between participation in the three screening programmes and various population characteristics for all English general practices with complete data in the Fingertips database curated by Public Health England. This database reports health related data for England aggregated by administrative area.

General practices with higher proportions of unemployed patients and smokers had a lower rate of take-up of all three screening programmes. Conversely, general practices from areas with less deprivation, with more patients who are carers or have chronic illnesses themselves, and with more patients satisfied with the provided service were significantly more likely to attain high coverage rates in all programmes (Source:  Torjesen, 2019).

To determine how many women participate in all three recommended cancer screening programmes (breast, cervical, and bowel). During their early 60s, English women receive an invitation from all the three programmes.

For 3060 women aged 60–65 included in an England-wide breast screening case–control study, we investigated the number of screening programmes they participated in during the last invitation round. Additionally, using the Fingertips database curated by Public Health England, we explored area-level correlations between participation in the three cancer screening programmes and various population characteristics for all 7014 English general practices with complete data.
Results

Of the 3060 women, 1086 (35%) participated in all three programmes, 1142 (37%) in two, 526 (17%) in one, and 306 (10%) in none. Participation in all three did not appear to be a random event (p  less than 0.001). General practices from areas with less deprivation, with more patients who are carers or have chronic illnesses themselves, and with more patients satisfied with the provided service were significantly more likely to attain high coverage rates in all programmes.

Only a minority of English women is concurrently protected through all recommended cancer screening programmes. Future studies should consider why most women participate in some but not all recommended screening.

 

See also: King’s College London Only a third of women take up all offered cancer screenings, new research finds

BMJ Cancer screening: only a third of women in England take up all offers

Cervical Cancer statistics

Statistics from Cancer Research UK show that in 2015 there were around 2,500 new cases, and nearly 700 deaths attributable to cervical cancer, in England. The overall age standardised incidence rate has been declining since the 1990s, however incidence is increasing in younger women.

Cervical cancer is 99.8% preventable through the cervical screening and the human papilloma virus (HPV) vaccination programmes. A cervical screen collects cells from the cervix to be tested for abnormalities. In 2019, primary HPV testing will also be introduced as part of the screening process.

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Most cases of cervical cancer are linked to HPV and the vaccine, currently offered by the NHS for free to girls aged 12 and 13 in UK schools, protects against the most of the virus strains responsible. The national HPV vaccination programme has successfully reduced infections of HPV type 16/18 in 16-21 year old women by 80%.

Full detail at Cancer Research UK

Campaigns

Cervical screening coverage rates in England fall

This report presents information about the NHS Cervical Screening Programme in England in 2016-17. It includes data on the call and recall system, on screening samples examined by pathology laboratories and on referrals to colposcopy clinics | NHS Digital

Key Facts:

• At 31 March 2017, the percentage of eligible women (aged 25 to 64) who were recorded as screened adequately within the specified period was 72.0 per cent. This compares with 72.7 per cent at 31 March 2016 and 75.4 per cent at 31 March 2012.

• A total of 4.45 million women aged 25 to 64 were invited for screening in 2016-17, representing an increase of 5.6 per cent from 2015-16 when 4.21 million women were invited.

• In total, 3.18 million women aged 25 to 64 years were tested in 2016-17, an increase of 2.9 per cent from 2015-16 when 3.09 million women were tested.

• Of samples submitted by GPs and NHS Community Clinics, 94.8 per cent of test results were returned Negative.

• 8.8 per cent of patients did not attend colposcopy appointments and gave no prior warning.

Full detail at NHS Digital: Cervical Screening Programme, England – 2016-17

Outcome and toxicity of radical radiotherapy or concurrent Chemoradiotherapy for elderly cervical cancer women

Concurrent chemoradiotherapy (CCRT) is the standard treatment for local advanced cervical cancer. However, for elderly patients, studies are limited and the outcomes are controversial | BMC Cancer

Methods: We retrospectively analyzed the elderly cervical cancer patients treated with radical RT or CCRT between January 2006 and December 2014. For external beam radiotherapy, 50Gy in 25 fractions or 50.4Gy in 28 fractions were delivered via 3-dimensional conformal radiation therapy or intensity modulated radiation therapy. High-dose-rate intracavitary brachytherapy was performed with a dose of 30-36Gy in 5–7 fractions to point A. Concurrent chemotherapy regimens included weekly cisplatin and paclitaxel.

Conclusion: Elderly cervical cancer patients could tolerate radical RT and CCRT very well and get a favored survival. Compared with RT, CCRT could improve the survival of elder cervical cancer patients with similar nonhematological toxicity. CCRT should be considered in elderly cervical cancer patients.

Full reference: Wang, W. et al. (2017) Outcome and toxicity of radical radiotherapy or concurrent Chemoradiotherapy for elderly cervical cancer women. BMC Cancer 17:510

HPV cervical cancer test introduced in England

BBC Health News. Published online: 4 July 2016

B0007449 Cervical Cancer
Image source: Katie Mayfield – Wellcome Images // CC BY-NC-ND 4.0

Illustration showing an artists interpretation of a Cervical cancer cell

The NHS in England is introducing a “superior” test for cervical cancer, following a successful pilot programme. Experts say it is a switch that could pick up an extra 600 cancers a year.

Women invited for a routine smear test will now automatically be checked for an infection called HPV (Human Papilloma Virus), which has been strongly linked to cervical cancer. Until now, an HPV test has only been done if doctors noticed abnormal cells in the smear sample.

Public Health Minister for England Jane Ellison said: “These changes are a breakthrough in the way we test women for cervical disease. The new test is more accurate, more personal and will reduce anxiety among women.

Read the full news story here