Demos: Save NHS £10m a year by increasing cervical screening uptake

– Think-tank report calculates the triple financial benefit of prevention and early detection of cervical cancer to NHS, Treasury and women who survive the disease

– Calls for ‘on the spot’ smear tests at GP clinics and awareness campaigns targeting specific communities to improve steadily declining screening rates.
Improving cervical screening rates would save the NHS £10m a year, according to a new study by the think-tank Demos.

Higher rates of cervical screening – which aims to prevent cervical cancer or diagnose it at an earlier stage – would also prevent the Treasury losing up to £6m in tax revenues, and significantly ease the impact on survivors’ personal finances.

In addition, figures show a 100% screening rate would cut the number of women facing cervical cancer by a third and reduce deaths by almost half, saving 1,176 lives over a 5 year period.

The findings, supported by Jo’s Cervical Cancer Trust, come at the beginning of Cervical Screening Awareness Week (June 8-14). Currently, around 3,000 women are diagnosed with cervical cancer every year and it is the most common form of cancer in the UK in women under 35.

The NHS currently spends over £21m a year treating cervical cancer patients, with the most expensive procedures often reserved for those with the most advanced cancers. Early stage or pre-cancer treatment costs as little as £500. By contrast, a full hysterectomy followed by a course of radiotherapy and chemotherapy can be in excess of £25,000.

Demos calculates that if all women were regularly screened the annual NHS budget for cancer treatment would fall to £12.1million.

The report goes on to highlight additional benefits to the wider economy. 84% of women were in work at the time when they were diagnosed with the disease. Almost half of working women had reduced their hours as a result of cervical cancer, while a further 27% had stopped working altogether.

Researchers calculate the resulting combined annual loss of income tax and NI contributions is £5.8m a year – much of which could have been avoided through screening.

Financial cost of cancer

As well as the well-documented health and emotional effects of cancer, the report discovers a significant financial cost on sufferers – with lasting effects even after women are cured of the disease.

Demos calculates that the combined financial burden of cancer-related costs, additional living arrangements and loss of income for women diagnosed with more advanced cancer is £1,102 a month. However, early detection reduced the financial impact on individuals and their families to just £360 a month.

Demos surveyed 182 cervical cancer sufferers to isolate the most significant costs. Increased insurance premiums, special equipment and hiring extra help such as childcare or cleaners were consistently the most expensive.

The majority of women also have to pay for private transport to and from appointments (66% of women), hospital parking charges (59%) and special dietary supplements or food and drink (49%).

‘On the spot’ checks

Latest figures show the number getting screened regularly has steadily declined over the past 15 years, with just 78.3% tested last year. Ethnic minorities, women from more disadvantaged communities and older women are all at greater risk of developing the disease.

A poll of almost 200 women across two NHS Trusts who had refused invitations for a smear test found the most common reason was embarrassment (35%). 1 in 6 said they were too busy or didn’t have the time (17%), while 15% replied that they had avoided the test because it was painful.

The Demos report proposes a raft of measures to reverse the tide of falling screening rates:

– GPs should offer ‘on the spot’ smear tests to women during other appointments to overcome the tendency of women to put off their screening, if they are overdue.

– Public Health England should trial local awareness campaigns, before including the most effective messages in their national Be Clear on Cancer programme, which currently excludes cervical cancer.

– Engage prominent voices, such as celebrities or religious leaders, to act as cervical cancer ambassadors to help overcome cultural obstacles to improving screening rates.

– Encouraging mothers and daughters to ‘pair up’ and remind each other to get screened – more effective than targeting them directly while also addressing two age groups (late 20s and over 50s) where screening rates are falling most rapidly.

Jo Salter, researcher at Demos and author of the report, said:

“With cervical cancer, the stakes are so high – both cost – and health-wise – but in many cases it can be avoided through screening. So it is worrying that so many women are currently ignoring their screening invitations.

We know that many obstacles stand in the way of cervical screening – nervousness, embarrassment, lack of time, lack of knowledge, overwhelmed services, and a feeling of ‘it will never happen to me’. It is crucial that these obstacles are removed, making it as easy as possible for women to make cervical screening part of their regular routine, as a smart, precautionary measure.”

Robert Music, Chief Executive of Jo’s Cervical Cancer Trust, said:

“The results of this report clearly highlight the urgent need to find ways to encourage more women to attend screening. By making a small investment in targeted prevention campaigns now we could not only save millions of pounds for the state but also prevent many more women from enduring the devastating long term implications of treatment as well as save lives altogether.

“We sincerely hope that cervical cancer prevention can be given greater priority at policy level. If the recommendations in this report can be taken forward, we may start to see a future where cervical cancer becomes a disease of the past.”

ENDS

NOTES TO EDITORS

The report, Behind the Screen, authored by Jo Salter is published by Demos on Monday 9 June 2014.

Additional figures

Minority communities: 23% of BME women said that they had never attended a screening appointment, compared to 14% of white British women. This number is even higher among first generation immigrant women – in a study of South Asian women, a third of those who had been born overseas had never been screened.

Older women: A third (31%) of women aged 50-70 surveyed did not consider screening necessary for all women, rising to 67% of women who had never been screened

Deprived communities: The 2012 Profile of Cervical Cancer in England showed that the average incidence of cervical cancer in the 30 most deprived Primary Care Trust (PCT) areas was 10.4 per 100,000 female population, compared to 7.8 in the 30 most affluent PCT areas

Lives saved: If we achieved a 100% screening rate – i.e. if everyone were screened regularly – deaths of cervical cancer would halve over a 5 year period, representing 1176 lives saved. Even a modest increase, from the screening current level to 85% nationally would achieve a 27% reduction in deaths over 5 years.

About Jo’s Cervical Cancer Trust
Jo’s Cervical Cancer Trust is the UK’s only charity dedicated to supporting women and their families affected by cervical cancer and cervical abnormalities. The charity also campaigns to increase awareness of the disease and bring down numbers diagnosed through promoting the cervical screening and HPV vaccination programmes. The charity’s national helpline is on 0808 802 8000.