Cervical cancer is the second most common cancer in young women under the age of 35 in the UK. This is an important issue for young women and I was surprised to learn that in 2004 the Government increased the age at which cervical screening begins from 20 to 25. This puts us out of step with Wales, Scotland, and Northern Ireland, who all begin screening at the age of 20.
Last month I tabled a Ten Minute Rule Bill in Parliament seeking to reverse this policy and make NHS bodies in England provide cervical screening for women aged 20 and above.
I am conscious that this issue arouses strong sentiment on both sides of the argument. Just as I have received impassioned letters of support from families who have lost a young woman to cervical cancer, I have also heard well-informed arguments from medical professionals firm in their belief that screening should begin at 25. But, fundamentally, this is a question of choice, and Marie Stopes, Jo’s Trust and the 178,000 signatories to The Sun’s petition on the issue all agree that the Government should lower the age of screening back down to 20.
We currently operate a two-pronged attack on cervical cancer through screening and vaccination. Regular cervical screening can detect and treat early the abnormalities which, if left untreated, could lead to cervical cancer. Over 90% of screening results come back normal, but for the few that do not, this test can, quite simply, make the difference between life and death. Additionally, the new HPV vaccination is given to all girls between the ages of 12 and 18.
Yet, there is a gap in coverage here – the vaccination programme ends at the age of 18 and the screening programme begins at the age of 25 – this leaves 1.3 million young women caught in medical limbo.
Screening and vaccination share a common purpose yet there is a contradiction in the Government’s policy. Even by its own admission, the Government does not yet know the full risks of the HPV vaccine, but it is nevertheless pressing ahead with the programme. Yet, the same lack of certainty exists in the risks outlined in the Government’s argument against reducing the screening age to 20. You cannot use the same rationale to support one cervical cancer prevention scheme yet deny it to another.
The Government’s justification for increasing the screening age to 25 is that cervical cancer is rare in women under the age of 25, the anxiety and stress of unnecessary investigation and treatment for abnormal cells is “proportionally excessive”, and that this age limit is now in line with WHO recommendations.
I agree that cervical cancer may be rare in women under 25, but, equally, each and every one of these cases is an individual tragedy, which should not be reduced to negligible statistics.
The stress and risks of unnecessary investigation and treatment are the main concern I have heard from medical professionals. I recognise their point, but as long as a young woman knows the odds of an abnormal smear not progressing to cervical cancer and the risks associated with any treatment, the decision of whether to proceed with screening and any further treatment should, by rights, be hers to take.
Although the Government claims raising the screening age to 25 brings it in line with WHO recommendations, in fact the age at which to begin screening varies across the world. Scotland, Wales and Northern Ireland have all kept their screening age at 20, Australia begins even earlier at 18, and America at 20, or within 3 years of first sexual contact. Our screening age of 25 looks positively out of step in comparison.
I fear this policy decision may be down to Budget restrictions. Gordon Brown’s catastrophic mismanagement of the country finances over the past 12 years means that Labour are now being forced to cut back on critical health services.
In recent years we have actually seen a decrease in the numbers attending for cervical screening and a concomitant decrease in cost. In particular, the attendance of those aged 25-29 has fallen from 79% in 1998 to 66% 10 years later and although the ‘Jade Goody’ effect may have increased the demand for screening, we cannot rely on these numbers being sustained. Furthermore, I am concerned that some young women may misinterpret the HPV vaccination as a ‘silver bullet’ solution, failing to see the relevance of attending a screening appointment.
What is so frustrating is that there was, until 2004, a good, sound policy in place. Ironically, the Government raised the age of screening at exactly the time young women are more at risk from cervical cancer than ever before. We need to be honest about changing lifestyles and, when contributory causes of unprotected sex and smoking are on the rise, we must be able to adapt policy accordingly.
Although my Bill did not make it to Second Reading, I hope that the Government does re-evaluate its policy and return the age of cervical screening back to 20. After all, when we have the means and opportunity to try and beat one of the deadliest cancers in this country, we must take it.