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Strategies to promote cervical screening for an aging demographic: a global insight

02 January 2025
Volume 36 · Issue 1

Abstract

Claire Mitchell and Alexandra Carlin use studies from around the world to explain how cervical screening can be boosted, and the role primary care nurses can play in doing so.

Cervical screening coverage, in the United Kingdom (UK), has been steadily declining year-on-year. Concurrently, the Human Papillomavirus (HPV) vaccination schedule excluded women born before 1990, therefore there is growing need to promote screening to those who were ineligible. Local data may help inform practices to identify non-attenders and allow development of targeted strategies to improve screening attendance with aim to meet the national target of 80%. NHS England aims to eradicate cervical cancer by 2040, however, much remains to be done to achieve this goal. Innovations such as self-sampling may be a vital tool to promote screening. This article will explore global targets, and the lessons learnt from countries with higher success rates, than the UK, in eradicating cervical cancer.

Since the introduction of the NHS Cervical Screening Programme in 1988, the number of deaths from cervical cancer has halved (UK Government 2023). Despite this success, cervical cancer incidence in the UK remains high, with latest figures from Cancer Research (2024) reporting around 3,300 new cases each year. It is estimated that 83% of cervical cancer deaths could be avoided if there was 100% screening coverage of eligible individuals (NHS England 2022). Coverage, which measures the percentage of eligible individuals over a defined period, is declining across all age groups, with no local authority in England achieving the 80% acceptable performance coverage level for cervical screening in 2023 (NHS England 2023a). Current attendance rates reveal that only 65.8% of eligible women aged 25-49, and 74.1% of eligible women aged 50-64 attended screening, (NHS England 2024b). Research into the key barriers has identified time constraints, fear of pain and embarrassment (Wilding et al. 2022). According to Jo's Cervical Cancer Trust (2020), barriers to attending screening can hugely vary across different ages and communities. The ability of nurses to identify and address the barriers is crucial for improving participation rates to ensure more eligible women benefit from screening.

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