I'm no stranger to those NHS letters dropping onto my mat; over the years I've had more than my fair share of "invitations for cervical screening." Not the most popular of invites, admittedly; I'd much rather it was a wedding invitation - or at least a birthday party. But cervical screening, or the 'smear test' as it's otherwise known, is a necessary procedure. There's not that much I take seriously in life, I'm a fun-loving kinda gal with a strong sense of humour, but I know that medical investigations are to be ignored at your peril - and I never have.
Despite my diligence in attending these appointments I had stage 3 CIN and subsequent treatment around 16 years ago, when I was 24 years old. I went on to develop an infection which saw me later have a partial hysterectomy and 3 failed cycles of IVF. It's taken time to accept that I will never be a mother. But do I regret attending the screening that diagnosed the pre-cancerous cells in the first place? Of course not. Had I not attended and simply carried on with my life in blissful ignorance, there's a high likelihood I wouldn't be here now. I had no symptoms, and the chances are that by the time I did, the cancer would have been fully established and may even have spread to the surrounding organs.
I have a filing cabinet stuffed full of correspondence relating to my ongoing treatment: the six-monthly screens and colposcopies...gradually moving to annual check-ups and eventually three-yearly smears. Occasionally I'd have an abnormal result again and need closer monitoring, but I've never had to have more cells removed; since my loop cone biopsy, they've returned to normal by themselves. As you can imagine, 16 years' worth of such treatment has resulted in quite a lot of paperwork.
So when my latest invitation arrived a few days ago I knew instantly what it was and tore it open eagerly (which may sound surprising, but no checks for three years has left me feeling anxious - like walking a tightrope between skyscrapers without a safety net).
Since I know the wording of these letters off by heart, I instantly saw the difference. My heart sank. Instead of being told clearly that my cervical screening test is due being (politely but encouragingly) asked to attend and given the telephone number to call, the new version of the letter takes an altogether more casual tone: Your choice. It's up to you whether or not to have cervical screening.
Wait, what?! No encouragement, no advice? The new letter has also been made completely impersonal with no signatory, no date of last smear or due date (as there was on the bottom of my 2012 letter) - not even a mention of the telephone number you need to call to make your appointment...
Over the years I've been vocal in my support of the screening. In recent months I have written about my experience on my blog (which got over 6k hits in the first week), had the article published on the front page here on HuffPostUK, and campaigned via social media to encourage women to attend. My campaigning has been picked up by several cervical cancer and gynae charities and women's health groups.
I recently attended an event organised by The Eve Appeal during Gynae Cancer Awareness Month. It's common knowledge that attendance rates for screening are in decline, yet not once has anyone mentioned this change in the way women are invited for testing as a possible contributory factor. I had no idea the letter had changed until I received my own a few days ago.
I'm all for freedom of choice, but during my campaigning I've discovered that most women know very little about their own bodies, cervical cancer causes and symptoms - or even how important the screening really is. Even some of my own friends - intelligent 40-something mothers who have witnessed my own traumatic experiences first-hand - admitted to me that they were clueless until they read my article. It seems that women are not attending mainly due to fear, ignorance or embarrassment.
Amending the letter in this way to dilute the message and imply that it's something that you can simply decide to ignore if you like, is at best irresponsible and at worst, negligent. We should be encouraging women to attend more, not less.
I intend to take this further. I need to find out why the wording has been changed at a time when diagnoses are up and attendance down. If the answer is not satisfactory, I will campaign to have the wording amended. The government may be willing to accept these women's deaths, the hundreds of heartbroken families left in their wake...but I'm not.
And to the 3.7million women in the UK who haven't attended their smear appointment in the last 5 years: do you really want to be next?
Cervical Cancer Facts:
- there are over 3000 new cases diagnosed in the UK annually
- it is responsible for 900 UK deaths a year
- cervical screening rates are in decline, with more than 1 in 3 women ignoring their letter
- diagnoses of cases in women aged 25-29 are the highest since 1999; up 60% in the last decade
- the UK has one of the lowest survival rates for the disease
- cervical cancer is the most common cancer in women under 35
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