20 Jun Britain’s Women – Scared to Screen
Just over 10 years ago, my classmates and I were rounded up and sent in a single file line down to the main assembly hall, there was a low rumble of excitement and a slight air of fear, the day had finally come upon us – the day of our HPV vaccinations. In 2020, NHS experts said that Britain is on its way to eradicating cervical cancer due to this vaccination, which is now also offered to teenage boys, and the updated NHS Cervical Screening Programme.
The current focus within the NHS, and rightfully so, has been on the prevention and early detection of several key cancers, including cervical cancer, given the better prognosis for patients when caught at earlier stages. In a bid to promote early diagnosis, the NHS have been in talks with supermarkets, underwear, and even tissue manufacturers to roll out a public awareness campaign that could see advice labels urging people to go for testing on their underwear and toilet roll in addition to the existing posters found in department store changing rooms.
However, the question could be posed as to whether awareness is truly the highest barrier to tackle when it comes to cervical cancer.
It seemed as though progress was being made, with a record 3.5 million women being screened for cervical cancer last year after the NHS ramped up testing once again following the pandemic. Despite this, women are continuing to miss out on cervical cancer screening. Earlier this year, it was reported that a staggering 4.6 million women failed to respond to an invitation to attend screening, highlighting that there is still a long way to go.
A core memory I have from the process of vaccination in school was the healthy dialogue it promoted around cervical cancer and the importance of screening in our not-so-later life. It meant that many of my peers were made aware of the cancer and were empowered with the knowledge to prevent it or seek help – lowering risks and improving lives. Despite this, we still had our walls up. The way we spoke about our bodies did not change much, and many of us at the time felt uncomfortable speaking about our vulvas, leaving us aware, but still too uncomfortable to report an issue if we recognised the newly taught symptoms.
A study by Jo’s Trust in 2018 found that the leading causes for women missing a cervical screening were embarrassment of their body shape, the appearance of their vulva, and concerns over smelling ‘normally’. Adding to this, OVID Health, in partnership with the Eve Appeal launched the campaign ‘Educating Eve’ in 2021, which polled the public and found that just 1% of parents used the word vulva with their daughters. In addition to these findings, many women refer to cervical screening as a “smear test” or “pap smear” to blur the language and discomfort of using certain medical terms.
When searching for synonyms for the word ‘smear’, I was presented with the words ‘defile’, ‘taint’ and ‘tarnish’ which are not the most agreeable terms to associate with having an examination on your vagina. Words can be extremely powerful, and these negative connotations and the lack of communication clearly spills into adulthood, promoting shame which can easily affect our conversations with clinicians when we feel something might not be right with our vulvas.
Back in 2019, as part of the NHS’ Long-Term Plan and Cervical Screening Programme, the NHS introduced a new more sensitive primary test for HPV and whilst this is a great development that will likely encourage women to attend a screening who may not have otherwise, it will not address the fundamental cause for many who fail to respond or action their call for testing.
Britain’s women must take pride in their bodies and promote a healthy dialogue surrounding our vulvas and cervical screening. This issue is not new, and this is definitely not the first article to address the shame attached to women’s health. Although progress has been made in terms of awareness, until we address and remove the stigma attached to our bodies and the language used to describe them, the running thread of shame and discomfort across all of women’s health will continue to bind us to worse health outcomes. Our bodies shouldn’t be a taboo and we should feel empowered to look after it, go for cervical screenings and say the word vulva!
Miriam Anorson, Account Executive