Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department is taking to improve cervical screening rates among people with learning disabilities.

The NHS Cervical Screening Programme in England offers screening to women aged 25 to 49 every three years, and women aged 50 to 64 every five years. Women aged over 65 should only be screened if they have not been screened since age 50 or if they have had recent abnormal results.

The NHS Cervical Screening Programme provides support leaflets for carers of women with learning disability to help them to make an informed decision and to understand the process. The leaflet is available at:

http://www.cancerscreening.nhs.uk/cervical/faq10.html

The NHS Cervical Screening Programme is aware that women with learning disabilities are less likely to attend their cervical screening appointment and are therefore working with Jo’s Cervical Cancer Trust to encourage these women to be screened. More information can be found at:

http://www.jostrust.org.uk/node/18658

The NHS Cervical Screening programme currently uses cytology as the primary screen. In April 2012 the UK National Screening Committee (UKNSC) gave its support for a pilot to assess the value of using human papilloma virus (HPV) as primary screening for cervical disease, rather than the currently used cytology test. The pilot is establishing the feasibility of using HPV as the primary screen for cervical disease in order to achieve better outcomes for women, while minimising over-treatment and anxiety, and whether it is practical to roll out nationally. The pilot sites, which began in May 2013, are: Liverpool, Manchester, Northwick Park (Harrow), Bristol, Sheffield and Norwich. An absence of HPV means that the woman’s risk of developing cervical cancer is very low. Strategies in which HPV was used as the first test (primary screen) were found to be both cost and life years saving. Cancer Research UK has estimated that, when fully implemented, HPV as primary screening could prevent an additional 600 cancers a year¹ . The UK NSC will open a public consultation shortly on whether HPV as primary screening for cervical disease should replace the currently used cytology test.

The Advisory Committee on Cervical Cancer (ACCS) met earlier this year and were given a presentation on whether self-sampling would be a feasible method in cervical screening. The ACCS acknowledged that various United Kingdom studies demonstrated an increase in uptake amongst non-attendees when self-sampling was offered. The ACCS agreed that self-sampling was a feasible strategy for HPV testing. However, further work would need to be undertaken before this could be piloted.

The Department funds the Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis led by the Wolfson Institute of Preventive Medicine, Queen Mary University of London. The unit is currently developing its work programme for 2016 and 2017, which may include topics relevant to cervical screening.

¹ http://msc.sagepub.com/content/early/2013/06/10/0969141313492313