Cervical Screening

Margaret Ferrier Excerpts

Monday 19th July 2021 Westminster Hall

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

It is a pleasure to serve under your chairmanship, Mr Pritchard, and an honour to speak in this important debate. It is an absolute pleasure to follow the hon. Member for Pontypridd (Alex Davies-Jones) and hear her personal story. I am sure we are all glad to see her today.

The petition is a proposal to introduce yearly cervical screenings for all women. As we have heard, the campaign for Fiona’s law was launched after the untimely death of 30-year-old mum Fiona from Kelso in the Scottish borders. Cervical screening is unequivocally the best method of protection against cervical cancer, and I think I speak for us all when I say that I hope to see greater uptake of screening. Unfortunately, prior to the pandemic one in four women across the UK did not accept their invitation for screening. The figure is higher in areas such as London and Glasgow, among women under 30 years of age, and among groups who face additional systemic barriers to their attendance—for example, this issue disproportionately affects LGBTQ people, with 40% of lesbian and bisexual women in the UK having been told that they do not require cervical screening. Experience of trauma or violence can also deter women from attending, with 72% of women who have experienced sexual violence delaying or cancelling their appointments.

Most clinicians would largely disagree with the proposal to make cervical screening annual. The UK National Screening Committee sets the eligibility criteria for screening programmes and makes recommendations about changes in order to maximise the benefits and minimise harm. Cervical screening starts at the age of 25, not 18, as HPV is very rare in younger women, with fewer than four cases per 100,000, due to the high uptake of the HPV vaccine. Around 90% of HPV infections are cleared naturally by the body in two years, and many cell changes return to normal without the need for treatment. Research generally suggests that a lower screening age does not substantially reduce cases and can in fact lead to over-treatment, which can have serious implications on physical and mental health, including on the ability to carry a child to term.

A more viable option for increasing the uptake of cervical screening would be to roll out widespread HPV self-sampling, which would allow women to enjoy the comfort and convenience of performing the test in their own homes. Research by Jo’s Cervical Cancer Trust suggests this would greatly increase uptake, with 47% of women who rarely or never book a test preferring self-sampling to clinician-led screening. Only 9% preferred clinician-led screening, while 50% of women who are overdue for an appointment and 34% of women from black, Asian and minority ethnic backgrounds also preferred self-sampling. Some 63% of those living with a physical disability have noted that their disability made it impossible for them to attend screening. Making self-sampling possible would put the screening process into women’s own hands.

For that to be recommended by the UK National Screening Committee, far more research into this procedure is required. At the moment, only a few pilot schemes are being run: one in Scotland, in Dumfries and Galloway, and another in London. It is essential that progress on these vital studies continues. It would be helpful to know whether the UK Government plan to increase support for such schemes, to accelerate studies into the viability of HPV self-sampling nationwide, and to give an estimate of when the necessary research will be collected by NHS England.

While annual cervical screening may not be realistically viable or desirable, we can take concrete steps to ensure that access is widened, risk is adequately assessed and appointments are not missed. I hope the Department of Health and Social Care will take on some of these considerations, especially with regard to advancing the research into, and roll out of, home HPV self-sampling.