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Targeted messaging planned to encourage LGBT+ community to attend cervical screening

Women aged over 50 and the LGBT+ community among those less likely to attend cervical screening, studies have found.

CERVICALCHECK IS TO encourage women aged over 50 and members of the LGBT+ community to get a free smear test, based on studies that suggest these cohorts of people are less likely to attend cervical cancer screening.

An LGBT+ Cervical Screening Study recommended that CervicalCheck should promote training for cervical smear sample takers, and ensure sample takers are recommending cervical screening to members of the LGBT+ community.

The study, launched by the National Screening Service in partnership with LINC and CervicalCheck, also recommended that a section on the CervicalCheck website should be created for the LGBT+ community, and that a communications campaign should be developed to appeal to this group to take part in the free cervical screening programme. 

Dr Nóirín Russell, clinical director for CervicalCheck, said following the publication of the LGBT+ report that CervicalCheck would increase training and supports for sample takers; and provide more targeted messaging and campaigns for the LGBT+ community, working in partnership with the people being screened.

A recent study that looked at screening in older age groups found that women aged 50-59 who had had an abnormal smear test, and who later had no test aged between 60-64, had a high risk of developing cervical cancer (10 in 1,000).

For women who have had no cervical screening test in their 50s, one test between age 60-64 was found to halve the subsequent risk of developing cervical cancer from 8.4 to 3.5 per 1,000 people.

In September, the National Screening Service released an LGBT+ Cervical Screening Study, which examined the views of 450 LGBT+ people in relation to cervical screening in Ireland. 

The study found that the main barriers to attending cervical screening in the LGBT+ community included heteronormative assumptions made by healthcare professionals; and the person being asked heterosexual questions by healthcare professionals which do not accurately reflect their gender identity.

Dr Sarah Fitzgibbon, Primary Care Clinical Advisor with CervicalCheck, told The Journal that anyone with a cervix aged 25-65 should attend free cervical screening every three to five years, depending on their age and previous smear history.

“If a person isn’t currently sexual sexually active, that can sometimes make them feel that they do not need to attend for screening, and there has been maybe some misunderstanding about what ‘sexually active’ means.

They might assume that means that if they have had penetrative, heterosexual sex that they would need to attend for screening, whereas, what we know with HPV screening is that anybody who has ever been sexually active – and that does not need to mean heterosexual sex – that they would be at risk of HPV infection, which is a risk factor for developing changes in the cells in your cervix.”

In March last year, the CervicalCheck programme switched from doing cytology tests first, which tests for abnormal cells, to HPV-first testing. This is because the outcomes are better in this order they increase from 75% accurate with cytology first, to between 85-90% accurate with the HPV-first testing.

Though HPV is a common sexually transmitted infection which the body can clear up over time, coupled with cell abnormalities it can develop into cancer.

“Screening begins at the age of 25,” Fitzgibbon says. “For people under the age of 25, a lot will have HPV infection which can clear itself naturally over time. It’s more likely that it would be a transient infection in younger people.

“For people who have HPV infection after the age of 25, we know that for those people we need to keep a closer eye on their risk level, because they may be less likely to clear the HPV.”

Dr Fitzgibbon said that older women can benefit from getting regular smear tests.

“At the other end of the age scale, people once they’ve finished having periods often feel ‘Oh well, screening is not for me, I don’t have a period, why would I need a smear test?’ But that’s an awareness issue – in fact, we do encourage women to continue attending screening up to the age of 65.”

She said that if women aged in their 50s haven’t ever had a cervical cancer smear done before through CervicalCheck, that they will be “actively” encouraging them to take part in the programme.

“Women need to know that just because you haven’t had a test done before, and you’re 55 say, you absolutely can come in and have a test done. Once you’re in the eligible age category, you can you can come any time.”

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