Adapted from BMJ 13 Nov 2021 and 19 Feb 2022
The HPV vaccination programme was started in England in 2008 on 1st September. According to an observational study vaccination has almost eliminated cervical cancer.
The women who have benefitted are now 26 years old or younger. 13.7 million years of follow up of women aged 20 to 30 showed that vaccinated women had much lower rates of cervical cancer compared to unvaccinated women in previous cohorts.
The reduction ranged from 34% in those who were offered the vaccine aged 16-18, 62% for 14-16 year olds and 87% for 12-13 year olds. There were even greater reductions in grade 3 cervical intraepithelial neoplasia and the trend was similar regarding vaccination age.
The results would suggest that the earlier the age of vaccination, the better.
Although this is great news for younger women, those over the age of 26 are still at risk of cervical cancer. Despite this 30% of women who were eligible for screening did not take this up in 2021.
A survey of 3,000 patients asked “Why?”
Embarrassment was the most common reason for 42%. Difficulty fitting in appointments was the reason for 34% and concerns about it being painful was the reason for 28%.
My comment: In my experience as a GP, all of these reasons have validity. However, losing your life or fertility to cervical cancer is devastating. Most cases are avoidable by regular screening and early treatment of cervical lesions, since we don’t know which ones will go onto cause cancer in any individual. Well woman clinics and family planning clinics are often open in the evenings if Practice Nurse clinics are not suitable. Remember that (almost) every woman has a vagina, including the nurse or doctor who does your smear. She knows what it is like! Muscle tightening can cause pain and to reduce this I would suggest putting a pillow under your bottom and possibly getting 5-10mg of diazepam from your GP. You would then need someone to drive you to and from your appointment.