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Published: 17 January 2022

Women of menopausal age less likely to take up cervical screening invitations, putting them at increased risk of developing cervical cancer

CervicalCheck highlights common barriers women aged over 50 face, as part of Cervical Cancer Prevention Week 2022

Today, to mark Cervical Cancer Prevention Week (17 – 23 January 2022), Ireland’s population screening programme, CervicalCheck, is highlighting the inequities faced by women over 50 in accessing this vital health screen.

A new HSE public attitudes survey carried out by Core Research in 2021 has reported on the barriers women of menopausal age face when considering taking up their screening invitation. These barriers included a fear of the process; finding screening more uncomfortable at this age; and finding screening embarrassing. In addition, half of all women surveyed said a fear of finding something was wrong would deter them from attending screening, whilst 1 in 5 women said they were concerned about attending their screening appointment due to COVID-19.

Women and people with a cervix aged 25 to 65 are invited to attend free cervical screening every three to five years, depending on their age and previous screening history. However, new screening data shows that attendance declines as women age – meaning women over 50 are less likely to have any changes picked up and treated if they are there.

The National Screening Service programme is this week beginning a targeted campaign to raise awareness amongst women over 50 that screening is still for them – and that screening at regular intervals is one of the best ways to reduce their risk of developing cervical cancer. 

A recent study in Australia 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 higher 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.

Dr Sarah Fitzgibbon, Primary Care Clinical Advisor with CervicalCheck, said that women over 50 can benefit from regular cervical screening tests: “Once women have finished having periods they often feel, ‘Screening is not for me, I don’t have a period, why would I need a screening test?’ 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 screen done through CervicalCheck, the programme is “actively” encouraging them to take part: “We are letting women 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 come any time, and to any registered screener.”

CervicalCheck Clinical Director, Dr Nóirín Russell, urged women to talk to their GP or practice nurse about screening, if they were unsure if they were eligible, or had fears about the test. “Cervical cancer is typically slow growing – it typically develops over 10 to 15 years – so it is important for women to continue to come for screening at regular intervals pre- and post-menopause. We know that for some women the screening test can be more uncomfortable after menopause, and this might put them off coming. However, there are things we can do to alleviate this. We’d ask these women to consult their GP on ways to make the test more comfortable for them.”

Dr Russell said it was important for women to know also that they don’t have to attend their own GP practice for the test. “You can book your free HPV cervical screening test with any of the 4,500 GPs or nurses registered with the HSE.” Women can find a clinic near them on the HSE website - www2.hse.ie/screening-and-vaccinations/cervical-screening/where-you-can-have-a-cervical-screening-test.html

Dr Caroline Mason Mohan, Director of Public Health at the National Screening Service said: “It’s important for me that we do all we can in screening to give women who are at the age of menopause enough information to make a decision on whether screening is for them. Accessibility is very important to our programmes. Last year we produced an Equity Report to show all the work we have done so far to help people access our services. This year we are further developing an Equity Strategy, which includes the creation of more information for women of menopause age who are eligible for screening, to show our commitment to making sure everyone has a chance to use our services.”