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The National Screening Service launches LGBT+ Cervical Screening Study

(13 Sep 2021)

The National Screening Service today (Monday, September 13) launches its report entitled LGBT+ Cervical Screening Study, in partnership with LINC - a non-governmental organisation working with lesbian and bisexual women and their families, and CervicalCheck – the national cervical screening programme.

 

This study examines the knowledge of; attitudes towards; participation in; and experiences of cervical screening in Ireland. It was open to lesbian and bisexual women, trans men, non-binary, and intersex people.

 

Approximately 450 people who identify as LGBT+ took part in this study, between October 2020 and March 2021.

 

It was found that while the majority have said they had positive experiences of cervical screening, only about two thirds (or 66%) of people said they attended cervical screening regularly. This compares to 80% attendance by the general population.

 

Dr Sarah Fitzgibbon, Primary Care Clinical Advisor for CervicalCheck said: “One finding that stands out is the inaccurate information circulating in the LGBT+ community that cervical screening may not be necessary for them. CervicalCheck invites every person with a cervix in Ireland aged 25-65 years for free cervical screening, every three or five years depending on age. The aim of the programme is to detect abnormalities in the cervix that, if left untreated, could develop into cancer. Therefore it’s important that everyone who is invited attends.”

 

Anyone with a cervix is at risk from cervical cancer and should avail of regular screening (HSE.ie, 2020). International evidence, spanning more than two decades and from a broad range of countries, demonstrates that lesbian and bisexual (LB) women and gender minorities with a cervix (GMC) have significantly lower rates of uptake of HPV and cervical screening. This study sets out to examine the situation in Ireland against this backdrop.

 

The main barriers to attending screening were found to be: heteronormative assumptions made by healthcare professionals regarding their circumstances; the person being asked heterosexual questions by healthcare professionals which did not accurately reflect their gender identity, and fear of the test procedure itself. Over 62% of those surveyed do not state their gender/sexual identity when attending for screening.

 

LINC member and cervical screening advocate Ruth O’Mahony said: “A number of lesbian and bisexual women think they don’t need to go for screening because they are not having sex with men. And just like women in the community as a whole, many also don’t like the invasiveness of the procedure. A positive experience with your GP can help you focus on taking care of your body. And if you can see yourself represented in the information being given out about female health, you’ll be more likely to consider it’s for you.”

 

Dr Nóirín Russell, Clinical Director, for CervicalCheck said: “Following the publication of this report, CervicalCheck is committed to a number of actions, such as: increased training and supports for sample takers; inclusion of and communication with the LGBT+ community in cervical screening; more targeted messaging and campaigns for the LGBT+ community, working in partnership with the people we care for in screening; and further research.”

 

We look forward to implementing these recommendations alongside our partners in LINC and the wider LGBT+ community.

 

ENDS

Issued by HSE National Press Office on behalf of National Screening Service.

 

If you have any questions about the report email PublicHealth.Support@screeningservice.ie

 

Spokespeople

  • Dr Sarah Fitzgibbon, Primary Care Clinical Advisor, CervicalCheck
  • Dr Nóirín Russell, Clinical Director, CervicalCheck

 

The report is available here.

 

If you have any questions about cervical screening, please Freephone 1800 45 45 55 or email info@cervicalcheck.ie

 

Notes:

Despite widespread common perceptions among health professionals, as well as service users, that HPV is only spread during heterosexual sex, cervical cancer-related HPV can affect anyone with a cervix who has engaged in any sexual activity with another person, including sharing sex toys or skin-to-skin contact, regardless of the age, gender, or sexual orientation of either partner.

 

CervicalCheck

  • CervicalCheck, the national cervical screening programme in Ireland began in September 2008.
  • It provides free cervical screening tests for approximately 1.2 million eligible women and people with a cervix who are aged between 25 and 65 years.
  • The aim of the national programme is to reduce morbidity and mortality in the population through early detection of high grade CIN.
  • Early detection and treatment of high grade CIN greatly improves health outcomes and has led to a 7% reduction in the incidence of cervical cancer in the Irish population.
  • The programme screens around 250,000 women per year and this may rise to up to 300,000 people per year.
  • Since its inception, CervicalCheck has provided almost 3.2 million cervical screening tests and detected over 115,000 cervical abnormalities.
  • The programme has detected and treated 64,000 precancerous cell changes, many of which could have developed into cervical cancer if not detected through screening. In addition, CervicalCheck has detected 1,500 cervical cancers.
  • Each year in Ireland approximately 300 new cases of cervical cancer are diagnosed and 90 people die of the disease.
  • Approx. 50% of these diagnosed in well women who attend for a screening test.
  • However approx. 150 per annum are diagnosed in the symptomatic services e.g. in gynaecology clinics when they present with symptoms such as bleeding or unusual vaginal discharge in between periods, after sex or after the menopause.

 

New programme

  • HPV cervical screening was introduced on 20 March 2020. Before this time, CervicalCheck used cytology screening, where the samples of cells of the cervix were looked at under the microscope. This was a good test used internationally and reduced incidence and mortality from cervical cancer.
  • The programme changed to primary HPV screening because it is a better test than cytology for identifying people at risk of having high grade changes in the cells of the cervix.
  • HPV is the cause of the majority of cervical cancers. Without HPV women are extremely unlikely to develop cervical cancer. Cervical screening aims to reduce the rate from the most common type, squamous cell cancer (approximately 70-80% internationally) and 99% of them are caused by HPV.
  • We know that if abnormal cells develop on the cervix, this is almost always (99% of the time) because HPV is present. If the HPV infection spontaneously clears, the cervical cells will almost always return to normal. It is extremely rare for precancerous cells to persist or progress in the absence of HPV.
  • A negative HPV test is a better predictor of being at low risk of developing cervical cancer than the presence of abnormal cells. This is why women with a negative HPV test are advised to return to routine screening. Unlike some other cancers, there is no evidence to show genetic pre-disposition to cervical cancer.
  • People invited for screening through the CervicalCheck programme, are actively made aware that although HPV cervical screening is a new and better test than cytology screening, there is no cervical screening test that detects all abnormal cell changes. This is because screening is like using a sieve for the whole population. The idea is to use the test (the sieve) to ‘catch’ as many people as possible with the condition and as few people without it as possible. All the people ‘caught’ in the sieve then have more complex tests (diagnostic test) to see if they actually have the condition (true positives) or not (false positives).
  • There will always some people with the condition that will fall through the ‘sieve’ and not have their increased risk detected. There are also people who are caught in the ‘sieve’ and told they have a problem whereas it turns out that they do not. They are at risk of over-treatment, side effects from treatment and anxiety.
  • All screening programmes are a balance of potential benefits, potential harms, and cost-effectiveness. More information on the potential harms and benefits is available on www.hse.ie/cervicalcheck or Freephone 1800 45 45 55.

 

Is cuid den tSeirbhís Náisiúnta Scagthástála é CervicalCheck
Bosca Oifig Phoist 161, Luimneach
Saorghlao 1800 45 45 55
CervicalCheck is part of the National Cancer Screening Service
PO Box 161 Limerick
Freephone 1800 45 45 55

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Is cuid den Rannóg Sláinte agus Folláine i bhFeidhmeannacht na Seirbhíse Sláinte í an tSeirbhís Náisiúnta Scagthástála. Cuimsíonn sí BreastCheck – An Clár Náisiúnta Scagthástála Cíoch, CervicalCheck – An Clár Náisiúnta Scagthástála Ceirbheacs, BowelScreen – An Clár Náisiúnta Scagthástála Putóige agus Diabetic RetinaScreen – An Clár Náisiúnta Scagthástála Reitiní do Dhiaibéitigh.

The National Screening Service is part of the Health and Wellbeing Division of the Health Service Executive. It encompasses BreastCheck – The National Breast Screening Programme, CervicalCheck – The National Cervical Screening Programme, BowelScreen – The National Bowel Screening Programme and Diabetic RetinaScreen – The National Diabetic Retinal Screening Programme.