Cervical Screening

Alex Norris Excerpts
Monday 19th July 2021

(2 years, 8 months ago)

Westminster Hall
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Alex Norris Portrait Alex Norris (Nottingham North) (Lab/Co-op) [V]
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It is a pleasure to serve under your chairship, Mr Pritchard. I would not normally make the Front-Bench contribution for the Opposition virtually, but I am afraid that I, too, have been pinged by the NHS app, so I am beaming in live from Nottingham. I thank my fellow pingee, my hon. Friend the Member for Gower (Tonia Antoniazzi), for securing the debate through her role on the Petitions Committee. The points that she made about testing have been a common thread throughout the debate, but she also mentioned the impact of covid, which I will reflect on shortly.

The petition has received close to 150,000 signatures, which is frankly an incredible effort. As well as showing the strength of feeling on this important topic, it is a physical demonstration of the legacy and impact of young mother Fiona Mathewson, who tragically lost her life to cervical cancer last April, at the age of 30. I send my best wishes to the Mathewson family—Andrew, Harry and Ivy. I lost my father to cancer when I was Harry’s age, and I know the impact that it has on a family. I hope the Mathewson family can take comfort from the incredible campaign that they have run, and from the way that they have been able to turn such awful grief into positive action. It is because of them and because of Fiona that we are here today. I hope they have seen that across the debate all four countries of the UK have been represented with very thoughtful and impressive contributions, starting with their own Member of Parliament, the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont). He mentioned the twin giants of prevention—screening and HPV jabs. I, too, will reflect on those.

My hon. Friend the Member for Pontypridd (Alex Davies-Jones) was very generous with her personal experience, and we are glad that it has had the ending that it has had. It might make people watching the debate think about a screening they have missed, whether it relates to their cervical health or otherwise. That is a really important lesson that people have taken from her, and I know that she inspires people in that way.

Important points were also made by the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) around health equity, particularly in the lesbian and bisexual community but also around those who suffer from sexual violence. We really must ensure that we tailor our messages and the way we contact people, in order to understand their different circumstances. They may present in different ways or need different support, and we would always want that support to be available to them.

As always, my hon. Friend the Member for Coventry North West (Taiwo Owatemi) brings her experience as a senior oncology pharmacist. She knows much about the impact of cancer on people’s lives and how to design cancer services. When we talk about covid in the cancer space, we generally talk about missed screenings, the backlog or late presentation, but she made an important point about the mental impact. It is hard for me to imagine what it is like to be called for a smear test, but she talked about hurdles getting in the way and said that this is very big hurdle that can make people set it to one side. That point was very well made and linked to what the hon. Member for Strangford (Jim Shannon) said about the importance of effective communication.

Finally, my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) talked about the importance of brilliant British science, which is something we have seen clearly over the last 16 or 17 months. We need to back our brilliant British science companies, in order to get the best possible outcomes for ourselves here in Britain, and around the world.

As we have heard, every year in the UK around 3,200 people get cervical cancer and Cancer Research UK estimates that 857 people died of cervical cancer in 2018. While the incidence rates have not fallen significantly in the last two decades, the good news is that mortality rates have continued to fall, especially among older patients. Since the beginning of the 1970s, the mortality rate has dropped from 10 women per 100,000 to approximately 2.5 per 100,000. That is significant progress that has saved the lives of many women.

The NHS cervical screening programme is a huge part of this, with the NHS estimating that it saves 5,000 lives a year, which is truly wonderful. In 2019, HPV primary screening was added to the programme, replacing cytology, as the hon. Member for Central Ayrshire (Dr Whitford) said—a major step that the NHS believe has the potential to eliminate cervical cancer by spotting earlier those 14 types in the HPV infection that combine to be the main cause of cervical cancer.

Earlier diagnosis makes such a difference; quite simply, it saves lives. Where the cancer is diagnosed at stage 1 or 2, one-year survival is over 90%, which drops to 75% at stage 3 and 50% at stage 4. Data from the National Cancer Intelligence Network also shows that the cervical cancer three-year relative survival rate is higher among people diagnosed by screening than by any other route. If there is a message to come out of today’s debate it is the importance of screening.

We know there is scope to improve in this area. Exciting new advances using mRNA, gene therapy, artificial intelligence, combination therapies, robotics and many more, such as those mentioned by my hon. Friend the Member for Wythenshawe and Sale East, will transform our care in cancer. As we restore services affected by the pandemic, we should not be looking to restore what we had 18 months ago, but to embrace new developments and build new pathways of care.

On screening frequency, which this petition relates to, cervical screening in England is offered to the cohort aged 25 to 64. While routine screening is now offered every three years up to the age of 49, and every five years between the ages of 50 and 64, the UK National Screening Committee has recommended that for those who test negative for high-risk HPV, the interval can be extended to five years. I understand that this will be implemented once necessary IT developments allow it. Can the Minister confirm when that is likely to be?

I fully sympathise with and appreciate the arguments for more screenings that have been made in the petition. Any lives saved strengthen the case far more than anything I can say, but I strongly believe that it is right that this decision is made by the experts on the UK National Screening Committee and not by us politicians. Where clinical evidence supports their decisions to screen at the intervals they say and not to extend testing to 18-year-olds, which I know there have been calls for, then we support that.

Beyond that, the Government must do more to increase take-up and ensure that all those eligible for a cervical smear test attend their appointments when they are invited or as soon afterwards as possible. We must also ensure that preventative measures, such as the vaccination, get out into secondary schools and are fully taken up. I would be interested to hear the Minister’s reflections about further plans to develop this, because we know we are not getting it quite where we want to.

The aim is for 80% of women to access their test, with 75% being considered acceptable. In the year prior to the pandemic, it was 72%, a little bit up from 71.9% the year before. That is not where we want it to be and we must do something different. As my hon. Friend the Member for Gower said, the pandemic has worsened the situation.

Jo’s Cervical Cancer Trust estimates that around 600,000 cervical screenings failed to go ahead in the UK in April and May 2020. NHS England’s own data shows that no clinical commissioning group screened over 80% of eligible women in the third quarter of 2021. These numbers are people who could be living either with high-risk HPV or with cancer itself and do not know it yet. I hope that the Minister will expand on the data to paint a fuller picture of the situation as she sees it and to share with us the steps for how these services will be caught up, so that we can reach those who have missed out.

To conclude, those who raised this petition deserve real commendation for their excellent efforts. I am sorry that perhaps the evidence is not pushing us in the direction that they have encouraged us to take. However, I hope that when Harry and Ivy are teenagers, they might look back on this debate—perhaps wondering why we are all beaming in from different parts of the country, in our own bedrooms or in other rooms in our homes—and see that this was a galvanising moment for politicians to come together across Great Britain and Northern Ireland to improve screening rates and the uptake of the HPV vaccine. I also hope they see that, as we went forward, we embraced improvements in technology and cancer care, and that, as a result, we got more and more brilliant outcomes for women in this country. I hope that when they look back in many years’ time, they will be very proud of their role, and the role of their family and their family friends, in achieving that.