Karen GrantEvery three years, I receive a letter in the post. It’s an invitation that could change my life. Unfortunately, it is not an invitation to Bradley Cooper’s Hollywood mansion – it is, in fact, way more important than that. The invitation is for me to attend for my smear test. Every time the letter arrives, I feel my heart sink. I really don’t want to go. But, I know what it means and how important the test is in detecting early signs of cervical cancer.

“Every three years, I receive a letter in the post. It’s an invitation that could change my life. Unfortunately, it is not an invitation to Bradley Cooper’s Hollywood mansion – it is, in fact, way more important than that. The invitation is for me to attend for my smear test.”

I read the information leaflet that comes with the invitation and it tells me everything I need to know – most important of all, that a smear test could save your life. According to Jo’s Cervical Trust, cervical screening saves around 5,000 lives in the UK every year and the resulting treatment prevents 8 out of 10 cervical cancers from developing.

I make the appointment and go for the test, because I really don’t want cancer.

What is cervical screening?

Cervical screening is the technical term for a smear test. This is because the nurse will take a ‘smear’ or swab of cells from the inside of your cervix to send off to the lab for testing.  In the next year, the way cervical screening is done in Scotland will be changing. Cervical cancer can be caused by genetics, but in most cases it can be caused by a group of viruses called the human papilloma virus (HPV). People will still have a smear test, but instead of the cells being analysed in the lab for abnormal growth (called cytology), the cells will be put in a special liquid to be tested for the HPV virus. This gives a lot more accuracy to the test and means that people get their results back faster (within two weeks).

A vaccination programme has been in a place for a few years against the HPV.  Although effective against HPV, the HPV vaccine will not protect you against all types of cervical cancer. So even if you have had the HPV vaccine, you should still come for cervical screening.

The new standards

Nearly a third of eligible people in Scotland did not get their smear test in 2018.  According to ISD, the NHS’s statistical division, the majority of those individuals were from high deprivation areas, meaning that mortality from cervical cancer may be influenced by social determinants of health.

Although evidence suggests that cervical screening is highly effective, many people avoid cervical screening. This may be because they don’t understand what the test involves or they are embarrassed to go. We can address some of these issues within the standards. We can also think about the language we use to ensure that nobody is excluded because of their cultural background, gender identity or because they have a disability.

I have been developing standards with Healthcare Improvement Scotland for 10 years. Developing the cervical screening standards is my first project as a Programme Manager and has been one of the best projects I’ve ever worked on. The development group has been tremendous; so engaged, and the project has given me the opportunity to work with a wide range of people. I have been able to capture the most important elements of good quality cervical screening services, and listen to the stories of people who have experienced cervical screening services and any barriers they have faced or issues they feel are important to them.

“Although evidence suggests that cervical screening is highly effective, many people avoid cervical screening. This may be because they don’t understand what the test involves or they are embarrassed to go. We can address some of these issues within the standards.”

Even though I attend every one of my cervical screening appointments, I have learned so much more about cervical screening and how the NHS in Scotland works to deliver this. There have been snags along the way (aren’t there always?), but I’ll be sad, yet at the same time proud, when it’s finished.

The draft standards will go out for consultation for eight weeks. During this time, we are looking for people’s thoughts on the standards, to see if there is anything we have missed or need to change, and to make sure that the work we produce is informed by people’s real experiences and what matters to them.

Have your say

If you would like to provide us with your comments on the draft standards, please complete our online survey.  For more information, or if you would like to engage with us further, please contact hcis.standardsandindicators@nhs.net

Visit the Healthcare Improvement Scotland website to download the standards.

The deadline for all comments on the draft standards is Friday 4th January 2019

Karen Grant is a Programme Manager within the Standards Team of Healthcare Improvement Scotland