Smear Not Fear #AwarenessSavesLives

The #smearnotfear team are a group of health professionals, from nursing (both trained, untrained and student nurses) and administrative backgrounds, from the Gynaecology Out Patients Department at Hull Royal Infirmary. The team have one thing in common and that is the passion and drive to encourage women to attend for their cervical screening.

Cancer of the cervix is a cancer that starts within the cervix or neck of the womb. In the UK it is the 14th most common cancer in women, however it is the most common cancer in women aged between 25 and 29 years. Cervical cancer in most cases is avoidable.

With the current screening and immunisation programmes it is suggested that cervical cancer is 100% preventable.

However, the uptake for cervical screening is at an all time low within the UK. The 2018 figures show that just 73.1% of in Hull were taking the test. While within the East Riding 78.5% of women were taking a smear test. This is below the National target rate of 80% that is set by the NHS.

Public Health England are currently campaigning to raise awareness and are actively working with NHS England in an effort to improve cervical screening coverage.

With this in mind something proactive was needed to help overcome fears and encourage the women in our area to uptake their screening invitation. It is suggested that 71% of women feel scared to have their smear test and thousands of women still ignore cervical screening due to embarrassment. Many women find the smear test invasive, humilitaing and degrading. The #smearnotfear team decided that the best course of action was that the team go out in the community and became accessible to women to allay fears of the smear test. The team go to public events such as HULL PRIDE (Nationally the lack of cervical screening in the LGBT community has been highlighted in a recent PHE survey) sporting events, bowling allies, vulval cupcake making classes, shops, Hull Health Expo and Hull Show to establish relationships, promote and encourage cervical screening.  

Teal is the colour of cervical cancer awareness and the team made the colour of the campaign teal based. Teal coloured lollipops are given out to give a teal coloured tongue. Teal coloured business cards, with our contact details on are given out and hands are stamped with our smearnotfear logo. We also do teal glitter face painting!

The #smearnotfear team have been entirely self-funding in their venture. We have paid for promotional items out of our own money and time spent at events has been completely voluntary. We are currently in the process of becoming a registered charity. Our ultimate aim would be to raise enough money to purchase a mobile unit to go out to the women in the community and perform smear tests, similar to breast and retinal screening. In the meantime, we will continue to raise awareness giving out our teal lollies, stickers and hand stamps.

As many young people use a social media platform, a #smearnotfear Facebook page was set up. This also acts as a support for our colposcopy patients. They can contact/message us whenever they want if for advice or reassurance. This service is very popular and invaluable to our women. We always receive positive feedback on this service. Following our first visit to the Hull Pride event there was 1,400 hits on the face book page in 24 hours! The Facebook page continues to be highly successful with frequent new followers added every day. Many people share our regular smear-based posts with friends. We realise that we are reaching out to more women than we know. We now have an Instagram and twitter page.

Following our attendance at the Hull Health Expo event, we have been asked to talk in schools and colleges. We have dates for these in the New Year.

The team continue to offer support to encourage women to have smear tests and offer ongoing care to those women following an abnormal smear test and colposcopy. Our achievements have been recognised by the Trust. In 2018 Sarah Bolton, Nurse Colposcopist was the winner in the most outstanding nurse/midwife and in 2019 the #smearnotfear team were runners up in the making it better category in our Golden Heart awards.

HUTH serves Hull and Parts of East Riding. The Hull CCG has an eligible population of approximately 75,000 women and East Riding 72,600 women. A combined total of 147,600 women who need to have cervical screening.

Kingston upon Hull is one of the 20% most deprived districts in England, with 31.5% of children living in poverty. The incidence of cervical cancer in Yorkshire and Humber is known to be the second highest rate in the country.

When we embarked on #smearnotfear in 2018, the cervical screening coverage was just 73.1%  in Hull, while within the East Riding 78.5% of women were uptaking the cervical screening test. This was below the National target rate of 80% that is set by the NHS.

The updated figures for cervical screening coverage April to June 2019 for women aged 25 to 64 in Hull CCG is 74% and East Riding CCG is 79.4%. The National Standard remains at an 80% requirement for cervical screening uptake.

These figures indicate that the uptake for cervical screening has improved in our catchment areas. I would like to think that the #smearnotfear team has played some part on improving the increase of uptake on cervical screening in our area.