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Sasha Pillai

Created on October 25, 2025

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Transcript

Improving Cervical Screening Uptake:​ A toolkit of information and resources for general practice​

Published December 2025

Contents

1. Purpose of toolkit

2. Understanding cervical cancer

3. Epidemiology in the UK

4. Understanding barriers to screening​

5. Strategies for improving uptake

6. Engaging hard to reach groups – incl. MH/LD​

7. Promoting awareness and education in the community

8. Optimising the screening experience for patients​

9. Building a team approach to improving uptake – every contact counts​

10. Data collection and monitoring​

11. Best practices and clinical protocols​

12. Resources and tools​

Summary key points

Purpose of toolkit

  • Improve cervical screening uptake across general practice
  • Prevent avoidable cases of cervical cancer and pre-cancer
  • Reduce inequalities affecting underserved populations
  • Strengthen patient experience, communication and trust

Understanding cervical cancer

  • Cervical cancer is one of the most preventable cancers
  • Nearly all cervical cancers are caused by persistent infection with high-risk HPV
  • It typically develops slowly, giving a longer window where precancerous changes can be detected and treated
  • Screening and HPV vaccination both support prevention of cervical cancer by identifying changes before they progress to cancer and preventing most high-risk infections.
  • Early diagnosis = better prognosis

Epidemiology in the UK

850
3,200
>90%

Deaths annually from cervical cancer

New cervical cancer cases each year

Survival rate when cancer found early

NHS England/WHO elimination strategy 2040

  • WHO global target: cervical cancer elimination as a public health problem​
  • WHO global initiative to achieve a below 4 per 100,000 cervical cancer incidence rate
  • NHS England outlined its ambition in 2023 to eliminate cervical cancer by 2040 aligning with WHO elimination strategy
  • UK strategy focuses on:​
High HPV vaccination coverage for all eligible adolescents​ High-quality cervical screening with strong uptake​ Timely treatment of high-risk findings​ Success relies heavily on community-accessible primary care

Understanding barriers to screening

Emotional and cultural barriers

Barriers related to perception of personal relevance

Practical barriers

Barriers in knowledge
  • Time constraints including availability of childcare
  • Concerns about cost - travel, time off work
  • Language issues
  • Lack of transport
  • Physical, social, or practical barriers associated with a disability, mobility, or obesity
  • Lack of choice of clinician performing the screening

Healthcare system and provided-related barriers:

  • Healthcare provider-related
  • System-related

  • Embarrassment
  • Fear of tests that could result in diagnosis of cancer
  • Reluctance due to previous negative experience such as pain or discomfort
  • History of sexual abuse or violence
  • Confidentiality concerns
  • Cultural issues (related to cirumstances, beliefs, background and inequalities in society)

Lack of knowledge about:

  • The purpose of cervical screening
  • The role of screening in prevention
  • The risks of cervical cancer
  • Who needs to be tested
  • Test accuracy
  • Cancer or belief that cancer equals death

  • Not belieiving cervical cancer is a risk
  • Not considering screening to be a priority
  • Limited previous experience of prevention or screening programmes
  • Being asymptomatic
  • Perception that HPV vaccinated people, women who have sex with women or transgender men do not require screening

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Title

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Patient-related barriers

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HPV vaccination

link to HPV vaccination toolkit

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