We all remember our first time. I was 25 when I had my first cervical screening.
I was nervous – not quite knowing exactly what I was doing or what to expect, bracing myself for discomfort. Trying to distract myself with thoughts of work, and the evening ahead.
We’ve all been there, except it’s only now that I’ve realised just how important those 10 minutes with my legs akimbo really were.
This week marks Cervical Cancer Prevention Week – from 17 to 23 of January, people nationwide will come together to raise awareness of cervical cancer prevention and the importance of cervical screenings, as we work to eradicate this disease that kills two people every single day.
However, the government needs to ensure that those who are called to have smear tests can receive paid leave to do so – as the inability to take time off work for the appointment is one of many tangible reasons that these potentially life-saving visits never get scheduled.
Shockingly, one in four women don’t attend their cervical screening. The reality we face is that cervical screening intake is falling across all age groups. This is for a wide range of reasons, including fear, discomfort and the inability to get a suitably timed appointment.
I know I have friends who lead very busy lives – people working flat out, who don’t have the luxury of flexitime and working from home, who simply don’t have a spare slot in the day to attend an appointment. For them, a smear test once every three or five years is something that can so easily fall by the wayside.
Risk of developing cervical cancer depends on many factors, including some potentially avoidable lifestyle factors like smoking.
Survival rates of cervical cancer are also significantly increased by early detection, which is why this week is so important – to convince everyone who needs to, to attend their cervical screenings.
If you can be guaranteed time off for jury duty, why not also time off for a smear test?
Amongst women aged 25 – 64, the rate of women attending their cervical screening when called has fallen from 75.7% in 2010/11 to 72.2% in 2019/20. These figures are way below what is considered to be the optimal performance standard of 80%.
In fact, in 2019, attendance at cervical smear tests was the lowest it’s ever been in England in two decades.
Lower attendance is also more prominent in under-represented groups such as those from lower socio-economic and BAME communities – and research showed that BAME women are twice as likely to be strongly worried about what a screening might discover than white women.
But, then again, it was also discovered that BAME women are a third more likely to feel unsafe visiting a doctor’s surgery now than white women.
Trans men and non-binary people are also less likely to attend their cervical cancer screenings, and face numerous barriers in accessing support, too. They report of discrimination from staff, and problems with computer systems that haven’t been updated – quite simply, they’re afraid.
The pandemic hasn’t made things easier, either, as one in three women said that the pandemic has made them feel less able to attend medical appointments – with problems reported including inflexible bosses, too much work, shift patterns and finding it difficult to ask to attend.
It doesn’t help that 2.5million appointments for cancer screening, tests and treatments have been delayed because of the pandemic, and that number only grows as the backlog continues.
What is most worrying about all of this is just how important early detection for cervical cancer is. If spotted in Stage 1, the survival rate is around 95% – yet if cervical cancer is identified in Stage 3, the survival rate plummets to a mere 40%. At Stage 4, it’s just 15%.
Cervical screenings also detect those who are at-risk of developing cervical cancer in the future and could prevent around 600 additional cancers a year – right now, they’re estimated to already save 4,500 lives annually.
But it feels as if our government is ignoring those, quite frankly, fatal figures. We need action from them. And we need it now.
We don’t need a ‘gimmick’ that will barely move the uptake needle, or a social media post that hardly anyone will see. We need a concrete change in the system – a guarantee that we will get time off to have a smear test that could potentially save our life.
With the government widening the gap between cervical screenings from three to five years in Wales, the long-term impact of this on top of the pandemic is at this stage difficult to predict – especially if this advice is put into place throughout the rest of the UK.
It’s high time that the people in charge of this country take the radical but sensible step of legislating for paid leave to attend cervical screenings. If you can be guaranteed time off for jury duty, why not also time off for a smear test?
There’s no doubt that some people will be able to get time off for cervical screenings, sure – but they will inevitably be those with better paying jobs. Those on zero-hour contracts, or on minimum wage, are less fortunate – with less flexibility.
This may mean that some are forced to take annual leave to attend their smear test – or risk their job if they call in sick, or turn up late for a shift as a result of a crucial appointment running over.
Aside from being unfair, it’s also not an option for everyone – what about those who may need to save annual leave for long school holidays, or those on part-time or shift work? For them, this may mean losing a day’s pay, or simply not attending.
Our lives are not a lottery. Nobody should be forced to lose out on something as important as a cervical screening. A smear test is not a holiday, it’s a vital medical examination. It should not come at the price of workplace or financial difficulties.
The government has a simple choice: they can choose to legislate guarantee paid time off for cervical screenings. It will amount to a mere half a day every five years – a meagre amount, but one that will save thousands of lives and potentially save the NHS millions in cancer treatment costs.
I also want to call on all companies with employees to commit to being a #TimeToTest employer.
We would encourage everyone to ask their HR department what steps they will be taking to support their employees to attend their cervical screening. And we call on the government to legislate a cast-iron guarantee for paid leave to attend a smear test.
At this stage, we have no time for dithering and delay – it’s our lives that count on it.
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