Cervical Cancer Smear Tests

Christian Matheson Excerpts

Monday 28th January 2019 Westminster Hall

[Christian Matheson (City of Chester) (Lab)]

It is a great pleasure to serve under your chairmanship, Sir Roger, and to take part in a debate in which there have been so many thoughtful and personal contributions. I congratulate my hon. Friend the Member for Warrington North (Helen Jones) on her detailed opening. I tried for some time to secure a debate on this subject, in order to raise the concerns of my constituents and others who were denied smear tests because they were under 25 and so did not receive a diagnosis of cervical cancer. My hon. Friend raised the case of a young lady who died of cervical cancer around Christmas. She believed that had she been allowed a smear test earlier, the cancer might have been caught at an early age.

My understanding of the campaign under way at the moment is that it does not necessarily aim to extend access to smear tests to all women under the age of 18; it argues, more simply, that a smear test should be carried out when a doctor believes it is necessary. I know of the case of a young woman, Lucy, who lives in a constituency neighbouring mine. She had a history of cervical cancer and so was given a smear test, but the lab did not even test the sample and destroyed it because she was under 25. She went on to develop cervical cancer—it was detected when she went for a private smear test. I am happy to report that it was eventually cured, but not without the difficulties of treatment.

My constituent Sophie wrote:

“I’m 23. I have two children (aged 5 and 16 months). When I was 17, I fell pregnant with my first son and my midwife asked for a smear test a few months after I gave birth, as I was suffering from abnormal pains in my pelvis area. My sister had been diagnosed with cervical cancer that year and my nan sadly died from it a few years before”—

So there is a family history. Sophie went on to say:

“I wasn’t given one, due to my age. Three years ago, I was suffering from pain again and they refused a smear, again due to my age, but used a cotton wool bud for a swab. This came back with abnormal cells and I was given antibiotics to clear these up and take the pain away. The doctor advised me if it carried on I would develop cervical cancer and may not be able to have further children. However, he did not refer me for a smear.

I had my daughter in June 2017 and still suffer from strange pains and, again, my midwife asked my doctor to refer me, but my age has always been a massive problem. I’m 23. I have two kids. I’m a law student, and it’s always in the back of my mind that, due to my previous abnormal cells, which they didn’t look further into, and my family’s history, I could potentially have cancerous cells I don’t know about, which would completely ruin and change my babies’ lives.”

Sophie concluded:

“I totally back you, Chris, with this, and hope that this legislation is changed. It’s totally against women’s human rights and discriminatory in age.”

The proposal is that women under the age of 25 should have access to cervical smears if they are needed. Objections to the proposal suggest that smear tests that are done too early might be inconsistent and inaccurate, and throw up false positives, as other hon. Members have mentioned. The campaign is not about testing all young women by extending the testing programme to 18 to 24-year-olds; it is about allowing a test only when the circumstances require it.

My hon. Friend the Member for Warrington North talked about the current regulations, which she believes are not being implemented. The regulations behind the 25-year age limit are now 13 years old, and they have not been reviewed in that time—my hon. Friend therefore asked the Minister that they be reviewed. The Smear on Demand campaign has prepared an extensive research paper that shows that the initial figures used 13 years ago to justify the 25-year age limit may have been incorrect, as they related only to when patients were diagnosed with stage 1B onward, as opposed to stage 1A. Many of the high-profile cases that we have heard about today were initially diagnosed with stage 1A. The campaign looked at figures for women under 28. The number of women diagnosed with stage 1A is highest in those aged 25—the figures start only at 25 and are not collected before then.

The smear test is supposed to be a preventative measure, but women can access it only at 25. It makes no sense to remove the possibility of prevention for the lower age limit. I do not think that it is in dispute that 25 is a good age at which to start routine smears, but when a doctor believes that a woman under that age needs a smear test, it should surely be allowed on the NHS. The campaign is not asking for all women under 25 to be tested; only those for whom that is recommended by a doctor. Some 99.7% of cervical cancers are treatable, because cervical cancer goes through three stages of pre-cancer, which means that it can be very slow growing. Currently, a smear test is the only cancer-detection test available that can detect pre-cancers.

I welcome the Secretary of State’s commitment to prevention in the NHS strategy that he recently presented to the House. I also welcome his commitment, which he gave to me in the main Chamber, to asking Mike Richards to look into the issue. I have not yet heard from Sir Mike, but I am sure that he will soon be in touch following the Secretary of State’s commitment. The House is currently dealing with some very difficult, intractable and divisive issues. This is not one of them. It is an easy issue for which a Minister can perhaps change the regulations and direct that if a doctor believes that a young women under the age of 25 has symptoms that require investigation, they are investigated. That is a minor change that could have major consequences. In these difficult times, I urge the Minister to apply some common sense and grab that chance with both hands.