Young women shunning smear tests

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Thousands of young women are failing to have cervical smear tests, figures for England have revealed.

The NHS Cancer Screening Programme says the number of women aged 25 to 29 who attended last year was down to 69%, compared to 79% 10 years ago.

That means around 68,000 fewer women are being tested each year, so early pre-cancerous signs could be missed.

Experts say women may have problems getting appointments, and be less aware that cervical cancer can be fatal.

It is worrying that the very women most at risk of precancerous cervical disease - younger women - are those that are choosing to stay away Professor Alison Fiander, University of Cardiff

Women aged between 25 and 64 are invited for smear tests every three to five years.

The test does not check for cancer cells, but detects early abnormalities which, if left untreated, could lead to cancer in the cervix.

Deaths from cervical cancer have been falling, but the disease still claims the lives of around 1,000 women each year in the UK.

'Embarrassment'

The figures published by the NHS Cancer Screening Programme show around 660,000 women aged 25 to 29 are invited for screening each year.

But the number actually attending has been falling year-on-year since 1995.

Experts warn that if women continue to miss smear tests, they risk warning signs being missed and cancer developing.

Attendance is also falling in women aged 30 to 34, down from 84.3% in 1995 to 78% in 2005/6.

A similar trend has also been reported in both age groups in Scotland and Wales.

Julietta Patnick, director of the NHS Cancer Screening Programmes, said: "We are currently exploring the reasons why women don't attend for cervical screening and our preliminary results indicate that they think it may hurt or that the experience will be embarrassing."

Dr Amanda Herbert, a consultant pathologist at St Thomas' Hospital, London, told the BBC there were other possible reasons for women not attending for testing.

"It's probably more difficult to get evening and Saturday GP appointments these days, so family planning clinics tend to get overloaded."

But she said she wanted women aged 25 and over to realise the importance of being screened.

"It's in young women that most of the pre-cancerous changes are detected and treated."

She said that, in women up to the age of 40, 80% of the most serious pre-cancerous changes - known as CIN3 - could be treated.

Vaccines

Dr Herbert said the recent publicity about cervical cancer vaccines which can protect against the disease could have deterred women from being checked.

But she added: "The vaccines are for the generations to come. It's an exciting development, but it's for the future."

Professor Alison Fiander, a gynaecological oncologist at the Wales College of Medicine, University of Cardiff, said: "It is worrying that the very women most at risk of precancerous cervical disease - younger women - are those that are choosing to stay away from screening in increasing numbers.

"CIN3 rates have been rising in women since the late 80s. The peak incidence occurs in the 25-29 year old age group.

"Although cervical screening has reduced the number of cases and deaths from cervical cancer the challenge is now to address an epidemic of CIN3 in young women."

Pamela Morton, director of the cervical cancer charity Jo's Trust, said: "Women in the UK are fortunate to be invited regularly for a free smear test so it is disappointing when 20% do not attend. For some this can have a tragic outcome."