Top picks: 13 resources about improving access to cervical screening

Summary

NHS England has set a target that cervical cancer will be eliminated in England by 2040. Although progress has been made in detecting and treating cervical cancer, there are still many women who are reluctant to go for cervical screening, or who face barriers to accessing screening. These barriers include perceived discrimination, lack of understanding the risk of cervical cancer and unmet access needs. This contributes to persistent health inequalities amongst particular groups. Patient Safety Learning has pulled together 13 useful resources shared on the hub about how to improve access and overcome barriers to cervical screening.

Content

1. Cervical screening, my way: Women's attitudes and solutions to improve uptake of cervical screening
This research by Healthwatch explored why some women are hesitant to go for cervical screening. Based on the findings of a survey of more than 2,400 women who were hesitant about screening, it makes recommendations to policymakers on how to improve uptake, including:

• improvements to the way data about the disability and ethnicity of people attending screening.
• producing an NHS-branded trauma card for affected women to bring to appointments.
• ensuring staff are effectively trained on accessibility and adjustments to care.
• looking at the possibility of home-based self-screening.

2. Facing a smear test after my trauma

In this BMJ article, Ruth Ajayi shares her experience of cervical screening after a traumatic childbirth, and how healthcare professionals could offer more compassionate, flexible care.

3. Exploring the inequalities of women with learning disabilities deciding to attend and then accessing cervical and breast cancer screening, using the Social Ecological Model
Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. In this study, the Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England. The study highlights key barriers to access for women with learning disabilities.

4. “We’re not taken seriously”: Describing the experiences of perceived discrimination in medical settings for Black women
Black women continue to experience disparities in cervical cancer despite targeted efforts. One potential factor affecting screening and prevention is discrimination in medical settings. This US study in the Journal of Racial and Ethnic Health Disparities describes experiences of perceived discrimination in medical settings for Black women and explores the impact of this on cervical cancer screening and prevention. The authors suggest that future interventions should address the poor quality of medical encounters that Black women experience.

5. Top tips for healthcare professionals: Cervical screenings
This article by the Royal College of Obstetricians & Gynaecologists and the My Body Back Project offers tips for healthcare professionals to make cervical cancer screening attendees feel as comfortable as possible during their appointments. Cervical screening can be very daunting for some women, and for those who have experienced sexual violence it can be triggering and cause emotional distress. The article provides tips on communication, making the environment calm and safe, sharing control and building trust with women.

6. Cervical screening uptake: supporting positive patient experiences is key

In this blog, Steph explains why Cervical Cancer Prevention Week is an opportunity to validate and help improve patient experiences. She calls for more information to be shared with both patients and doctors that helps to increase compassion, understanding and accessibility.

7. Cervical screening for people with learning disabilities: Learning resource for sample takers

This learning resource from the NHS Wessex Cancer Alliance explains the misconceptions and barriers to cervical screening, the consent and best interest decisions, and the role of the sample taker and the reasonable adjustments that can be made.

8. The Eve Appeal: What adjustments can you ask for at your cervical screening?

The Eve Appeal want to raise awareness of what adaptations women and people with a cervix can ask for during their screening to make the appointment more comfortable.

9. How can reframing women’s health improve outcomes? An interview with Dr Marieke Bigg
Dr Marieke Bigg is the author of a 2023 book, This won’t hurt: How medicine fails women. In this interview, Marieke discusses how societal ideas about the female body have restricted the healthcare system’s approach to women’s health and describes the impact this has had on health outcomes. She also highlights areas where the health system is reframing its approach by listening to the needs of women and describes how simple changes, such as allowing women to carry out their own cervical screening at home, can make a big difference.

10. Having a smear test. What is it about?
This download A4 Easy Read booklet from Jo's Cervical Cancer Trust uses simple language and pictures to talk about smear tests. It explains what a smear test is, has tips for the person having the test and has a list of words they might hear at their appointment.

11. Health Improvement Scotland: Cervical screening standards

Published by Healthcare Improvement Scotland in March, the new cervical screening standards include recommendations to ensure women receive accessible letters and information about screening and healthcare professionals are trained to support women to make informed choices.

12. Cervical cancer screening in women with physical disabilities

This US study explored how the cervical cancer screening experiences of women with physical disabilities (WWPD) can be improved. Interviews with WWPD indicated that access to self-sampling options would be more comfortable for cervical cancer screening participation. The authors highlight that these findings that can inform the promotion of self-sampling devices for cervical cancer screening.

13. Cervical screening - a guide for survivors of rape, sexual assault and sexual abuse

This guide by The Eve Appeal and The Survivors Trust gives information about attending cervical screening for survivors of rape, sexual abuse or assault. It offers tips that may help patients feel more comfortable about their appointment. It is part of the #CheckWithMeFirst campaign to help raise awareness of the challenges survivors of rape, sexual abuse and sexual violence may face when accessing cervical screening.

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