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Cervical Cancer

Volume 78: debated on Monday 29 April 1985

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asked the Secretary of State for Social Services whether he proposes any changes to the Government's policy on cervical cancer screening.

Screening for cervical cancer can save the lives of many women. The Government recognise the importance of an efficient screening programme as a vital preventive health measure. We are satisfied with the present advice on age and frequency of screening and we intend to continue to improve its effective implementation.The biggest single problem is that the service is still not reaching sufficient numbers of older women. Many women who are no longer sexually active may believe they are no longer at risk. The vast majority of deaths, many avoidable, take place among these older women. All women of whatever age, who have at any time been sexually active should seek cervical smear tests at regular intervals.All district health authorities (DHAs) should already have systems for recalling women patients for tests at five-yearly intervals. These systems do not, however, contact women who have never been tested at all. We now wish to see greater use of computers to contact women who have never been screened. The Government have financed the development of standard computer software and the hardware needed to operate this system is not costly. We are therefore telling all DHAs to arrange with their corresponding family practitioner committees (FPCs) to implement such a system on their behalf. Already over one-third of FPCs are using computers for call or recall, or have firm plans to do so. We are now saying that all should do so. We shall want to know the date by which each authority proposes to implement full computerised call and recall.In addition, we want other available methods of reaching women most at risk to be used more extensively. Older women make considerable use of the primary care and hospital services. Their visits to doctors for any purpose provide opportunities for them to be offered a test. We shall be discussing with the profession and health authorities how GPs and hospitals should take advantage of these visits so that women who have not had a test during the past 5 years can be offered one. In this way, a steady increase in the number of women reached will be achieved.We also intend to improve the effectiveness of laboratory facilities for processing smears. We must ensure that in the longer term the right number of suitably trained and qualified staff such as histopathologists become available. In the shorter term, improvements may be possible if priority can be given to smears from women most at risk. We shall be discussing with the professions involved and with health authorities how we can best achieve these objectives.Finally, health authorities must ensure that there is effective follow-up of abnormal results. We believe that the possibility of error leading to tragic events can be considerably reduced by a simple administrative reform. We therefore want all authorities to move to a system where all women are notified that their test has been done and told who to contact for the result. We shall be discussing the details of this with the professions and authorities concerned.The recent adverse publicity has obscured the fact that many health authorities and individual doctors are, by implementing our policy, providing a good service to women of all ages and preventing unnecessary deaths. We want all authorities to match the best. In addition to the measures outlined above, we are therefore telling all authorities to review again the effectiveness of their programme and to inform us of the outcome. We will insist that any authority which is not adequately protecting women in its area takes immediate steps to do so.