400,000 extra women missed their smear tests during the pandemic - as charity says we may see a rise in cervical cancer cases

More than 400,000 extra women in England are behind on their cervical screenings compared to before the pandemic, with millions of women missing their appointments.

As the nation marks Cervical Screening Awareness Week, Jo’s Cervical Cancer Trust said “we may sadly see” a rise in cancer diagnoses following disruption during Covid.

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Analysis of NHS Digital data by NationalWorld reveals that, of the 15.6 million women and people with cervixes eligible for smear tests as of December 2020, just 10.9 million had been adequately screened.

That leaves 4.7 million who have not been screened, either because they have never had a test, or because their last test was longer ago than the maximum window between appointments – 3.5 years for those aged 25 to 49 and 5.5 years for women aged 50 to 64.

The figures mean there are now an extra 419,715 women not adequately screened compared to in December 2019, when 4.3 million had not been tested.

The coverage rate for cervical screening is now at 69.6%, compared to 72% a year ago. The target is 80%.

To get to the target, the NHS would have to screen an extra 1.6 million women.

The 80% target is not being met in any council area in England. Coverage ranges from a low of 47% in Kensington and Chelsea to a high of 78% in Derbyshire.

Why are cervical screening rates behind target?

Jo’s Cancer Trust says attendance at cervical screenings has generally been falling over the last two decades, and that Covid has created new challenges.

“This included disruptions to services across the UK and public uncertainty about attending,” chief executive Samantha Dixon said.

“Our research shows this was more pronounced among groups such as women from Black, Asian and minority ethnic communities.

“While cervical cancer is rare and usually develops slowly, a rise in diagnoses of higher grade cell changes and cervical cancers is something we may sadly see.”

Following a change in 2019, cervical screenings now check for the presence of the human papillomavirus (HPV), which causes over 99% of cervical cancers.

A soft brush is used to take a small sample of cells from the cervix, which is then tested for the virus. If certain types of high-risk HPV are found, the sample is tested again to check for changes in the cells that could develop in to cancer.

Previously the test looked for changes in the cells right away.

Appointments were postponed

The cervical screening programme in England was not officially paused during the pandemic, unlike in Wales, Scotland and Northern Ireland.

But Jo’s Trust says invitations in some areas were not being sent and appointments were postponed. They have since resumed.

The biggest drop in coverage during the pandemic has been among younger women aged 25 to 49, who were already much less likely to take up their screening offers.

In December 2019, coverage for this group was at 69.9%. It is now at 67.1%, a drop of 2.8 percentage points.

For women aged 50 to 64, coverage has fallen from 76.1% to 74.6%, or 1.5 percentage points.

Ms Dixon said: “Cervical screening remains the best protection against cervical cancer, preventing thousands of diagnoses every year.

“We would encourage those who are now overdue as a result of the pandemic or otherwise to book in, and ask any questions you have before if you need to.

“It is essential that we continue to shout about the importance of the test, and make sure everyone who needs support knows where to find it’”

Public Health England, which administers the screening programme, declined to comment.

You can book a cervical screening if you are due one by phoning your GP.

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