Women Should Be Offered Cancer Screening Checks During Lunch Breaks, Review Urges

This could be the future of breast and cervical screening to try and improve uptake.

We could soon be attending cervical and breast screening appointments on our lunch breaks, during an evening, or even at weekends, according to a new government-ordered review.

Professor Sir Mike Richards, the former national cancer director at the Department of Health, said patients need to be given more choice over where and what time they go for tests in a bid to halt the “worrying decline” in the number of people attending.

Attendance for cervical screening (smear tests) is at a 19-year low in England and a 10-year low in Scotland and Wales, according to the charity Jo’s Cervical Cancer Trust.

More than one in four women in the UK are not attending their appointments when invited. And, earlier this year, it was revealed that more than 1.25 million women had waited too long for smear test results in 2018. Failing IT systems were blamed – some of which have had issues since 2011.

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The study, led by Professor Richards, looked in detail at the NHS screening programmes for abdominal aortic aneurysm, bowel cancer, breast cancer, cervical cancer and diabetic eye screening.

It said outdated IT systems used for screening must be overhauled as they are currently “too fragmented and lead to errors, risking patient safety”.

The review suggested people would be more likely to accept invitations for screening if appointments were available at convenient times and locations – either near home or their place of work.

Some women may also prefer to be screened at sexual health clinics, while GPs must be “incentivised” to provide convenient appointments and ensure people take up screening, it said.

Text message reminders could also be sent to increase uptake of appointments, although current IT systems hinder access to mobile phone numbers, the review suggested.

The study said trans people and gender diverse populations are “currently poorly served by screening services” and this must be improved. “Trans men may have a cervix and thus be at risk of cervical cancer,” reads the report. “However, their gender may be recorded as male and thus they would not be routinely called for cervical screening.

“Trans women are at an increased risk of breast cancer compared to cisgender men if using hormones, but are only invited for screening if registered as female.”

The report said the current screening service saves over 10,000 lives a year but there is a sense “that we are now slipping” and each screening service could “do better”.

It was also unclear who is accountable for the screening service – with Public Health England (PHE) and NHS England both having key roles – and the report said responsibility must be transferred to NHS England.

Simon Stevens, NHS chief executive, welcomed the report and said the recommendations were “sensible”. All commissioning and delivery of screening will now move to NHS England, while PHE will host expert advice and recommendations.

Sara Hiom, Cancer Research UK’s director of early diagnosis, said: “Thousands of premature deaths are avoided every year in the UK thanks to our cancer screening programmes, but there are still many things holding them back.”

She said a lack of funding has led to an “archaic NHS infrastructure” – especially IT systems – making it hard to optimise the country’s screening programmes.

“The Department of Health and Social Care must take urgent action to ensure the review’s recommendations are implemented so that no lives are needlessly lost to cancer,” she added.