Comment from :

Adeola Olaitan, Consultant Gynaecologist, UCLH and Medical Adviser to The Eve Appeal

Dr McCartney's claim that women are ill/under informed on cervical screening and denied the autonomy to decide for themselves is incorrect and potentially damaging.

http://www.bbc.co.uk/programmes/b01ddxbm#p00qzt1r - chapter 3

Dr McCartney claims that screening benefits only 1:1000 women ie that 1000 women would need to be screened for 35years to prevent one death.  Figures issued by Cancer Research UK and academic research institutions indicate otherwise (Saseini et al Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data BMJ 2009; 339 doi: 10.1136/bmj.b2968 (Published 28 July 2009)  The UK's NHS Cervical Screening Programme is estimated to save up to 5,000 women's lives in the UK each year - 1:65 women. In fact the biggest risk factor for getting cervical cancer is not going for smears.

Cervical screening detects abnormal cells in the cervix which may develop into cervical cancer and this early detection and treatment prevents up to 75% of cervical cancers from developing. These abnormal cells cause no symptoms and the only way of detecting them is going for cervical screening. Cervical screening began in Britain in the mid-1960s and the NHS Cervical Screening Programme was set up by the Department of Health in 1988 since when the incidence of cervical cancer has almost halved.  It is vital to encourage women to attend regular screening when invited.

As a specialist in gynaecological cancer, I think it is a tragedy when a woman is diagnosed with cervical cancer because she has not attended for cervical screening. Sadly this is not a rare event and I see up to 6 such women a year.

Dr McCartney is concerned about over-diagnosis and over-treatment as a result of false positive results.   90-93% of results are negative. In addition there are strict guidelines for the treatment of women with abnormal smears and as a consequence most gynaecologists manage women with low grade abnormalities conservatively.

There is a wealth of information provided to women by the NHS Cervical Screening Programme on invitation to their first screening, in addition to information readily available on the website http://www.cancerscreening.nhs.uk/cervical/about-cervical-screening.html, in GP surgeries, schools and provided by charities such as The Eve Appeal www.eveappeal.org.uk

Adeola Olaitan

Consultant Gynaecologist, UCLH and Medical Adviser to The Eve Appeal