The new campaign, titled ‘You wouldn’t miss...’ demonstrates that attending screening is just as important as collecting the kids from school or a going to a job interview. The posters and postcard campaign, designed by Manchester Mental Health and Social Care Trust’s Public Health Development Service, are aimed at 25-34 year old women but are applicable to all ages. They feature real women from Greater Manchester and remind women that there are certain things that they would not miss doing, such as collecting their children from school. The posters stress that their cervical screening test, which is usually provided by their GP, is also something that they should not miss.

Photo from left to right:
Yang Zhang, Alpa Raja, Angela Osei and Michelle Dooley.

“The problem we face is that a lot of women see a screening as being just about detecting cervical cancer, but it is actually a preventative measure,” he said. “The higher rate of cervical cancer in Manchester can be directly attributed to the low uptake of screening and we hope that this campaign will go some way to addressing that.”

Since the introduction of the National Cervical Cancer screening programme in 1988, the number of women from 25 to 64 that are diagnosed with cervical cancer almost halved - from 16 women in every 100,000 women between 1986 and 1988 to 8.5 women in every 100,000 women from 2006 to 2008.
However, in Manchester the rate for 2008 was 19.2 women in every 100,000, which is more than double the national average.

“This is a first step in a rolling and continuing campaign and we’re making sure that the information is also available in a number of languages including Polish, French, Mandarin Chinese and Urdu among others,” said Paul. “Screening saves lives, so if you have received an appointment to attend for a smear test, I would strongly urge all women to keep that appointment and get checked out.”

If you have received an appointment for a cervical smear recently, and did not attend, please contact your GP practice to ask to rearrange the appointment. Alternately, you can attend a sexual health clinic such as the Palatine Clinics, which are held at a number of locations across the City of Manchester. Further details on locations, opening times and contact numbers can be found by clicking here.

The posters and accompanying postcards are available directly from the Manchester Public Health Development Service and are being distributed to healthcare facilities, libraries, community centres and other venues across Manchester.

For more information please contact the Public Health Development Service Library and Information Resource Centre.

Further information and Frequently Asked Questions about Cervical Cancer can be found below, after the downloadable PDFs of the campaign posters and postcards.

Cervical screening Poster 1	Updated: 09/01/13	504KB
Cervical screening Poster 2	Updated: 09/01/13	592KB
Cervical screening Poster 3	Updated: 09/01/13	2.3MB
Cervical screening Poster 4	Updated: 09/01/13	536KB
Cervical screening Postcard 1	Updated: 09/01/13	476KB
Cervical screening Postcard 2	Updated: 09/01/13	416KB
Cervical screening Postcard 3	Updated: 09/01/13	412KB
Cervical screening Postcard 4	Updated: 09/01/13	384KB
Cervical screening Poster - Mandarin	Updated: 09/01/13	1.8MB
Cervical screening Poster - Polish	Updated: 11/04/13	1MB
Cervical screening Poster - French	Updated: 11/04/13	873KB
Cervical screening Poster - Urdu	Updated: 09/01/13	1.9MB

Cervical Screening - Frequently Asked Questions:

What is cervical screening?
Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in a woman's cervix (the neck of the womb). The first stage in cervical screening is taking a sample using liquid based cytology (LBC).

A sample of cells is taken from the cervix for analysis. A doctor or nurse inserts an instrument (a speculum) to open the woman's vagina and uses a spatula to sweep around the cervix. Most women consider the procedure to be only mildly uncomfortable.

Early detection and treatment can prevent 75 per cent of cancers developing but like other screening tests, it is not perfect. It may not always detect early cell changes that could lead to cancer.

Who is eligible for cervical screening?
All women between the ages of 25 and 64 are eligible for a free cervical screening test every three to five years.

In the light of evidence published in 20031 the NHS Cervical Screening Programme offers screening at different intervals depending on age. This means that women are provided with a more targeted and effective screening programme.
The screening intervals are:

The NHS call and recall system invites women who are registered with a GP. It also keeps track of any follow-up investigation, and, if all is well, recalls the woman for screening in three or five years time. It is therefore important that all women ensure their GP has their correct name and address details and inform them if these change.

Women who have not had a recent test may be offered one when they attend their GP or family planning clinic on another matter. Women should receive their first invitation for routine screening at 25.

Why are women under 25 in ENGLAND not invited?
This is because changes in the young cervix are normal. If they were thought to be abnormal this could lead to unnecessary treatment which could have consequences for women's childbearing.2 Any abnormal changes can be easily picked up and treated from the age of 25. Rarely, younger women experience symptoms such as unexpected bleeding or bleeding after intercourse. In this case they should see their GP for advice.

In June 2009 the Advisory Committee on Cervical Screening reviewed the policy of starting screening at age 25 and agreed unanimously there should be no change in the current policy.

The Committee did agree, however, that in order to ensure that all women are screened by the age of 25, invitations could be issued to them six months before their 25th birthday.

A research paper (Sasieni P, Castañón A, Cuzick J. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 2009; 339:b2968) focusing on women screened under the age of 25 was published in the BMJ. It stated:
'Cervical screening in women aged 20-24 is substantially less effective in preventing cancer (and in preventing advanced stage tumours) than is screening in older women'

Why are women over 65 not invited?
Women aged 65 and over are taken out of the call recall system unless they need ongoing surveillance or follow up. This is generally required if a woman has had an abnormal result in any of her three most recent tests or is recommended for early repeats owing to a previous abnormality.

Generally speaking, the natural history and progression of cervical cancer means it is highly unlikely that women of 65 and over will go on to develop the disease. Women aged 65 and over who have never had a test are entitled to one.

What about women who are not sexually active?
The NHS Cervical Screening Programme invites all women between the ages of 25 and 64 for cervical screening. But if a woman has never been sexually active, then the research evidence shows that her chance of developing cervical cancer is very low indeed. We do not say no risk, only very low risk. In these circumstances, a woman might choose to decline the invitation for cervical screening on this occasion. If a woman is not currently sexually active but has been in the past, then we would recommend that she continues screening.

I am in a same sex relationship. Do I need cervical screening?
The Human Papillomavirus ( HPV) which causes cervical cancer can be transmitted between women. Even women who have never had sex with a man can't be said to be at no risk of contracting the virus, only at low risk. Therefore it is still advisable to be screened.

What happens at a cervical screening appointment?

Invitation for cervical screening
You will receive a letter from your local Primary Care Trust or GP asking you to make an appointment for screening. You can choose whether to have it done at your GP practice or family planning clinic. Most women choose to have the test done by their GP or practice nurse. You can ask to have yours taken by a female doctor or nurse if you prefer.

Taking a sample
The sample taker should explain the procedure and you should feel able to ask any questions at any time. The doctor or nurse uses an instrument called a speculum to open up the vagina and then a spatula is used to "sweep" around the cervix (neck of the womb) and take a sample of cells from its surface. Most women consider the procedure to be only mildly uncomfortable.

Then the head of the spatula, where the cells are lodged, is broken off into a small glass vial containing preservative fluid, or rinsed directly into the preservative fluid. This is sent to a laboratory for examination under a microscope. Cytology - the study through a microscope of the cells - enables the tests to be grouped into different grades which determine what happens next.

What happens next?
You should receive the result of your test in writing in around two weeks from the date of your test.
Most women receive a normal result, which means that the cells were considered to be normal. These women are recalled for another routine test within three to five years. Of 3.3 million women aged 25 to 64 who received a result in 2010-11, 93.4 per cent had a normal result.

Some women receive an abnormal result. This means the laboratory has identified some cell changes which need further investigation. Not all abnormal changes need to be referred for immediate treatment; some may disappear without the need for any treatment. Depending upon the degree of changes, women may be asked to have a repeat test in six or twelve months, or may be referred for colposcopy.

A small proportion of women are asked to return for a second test as the first was considered to be inadequate. This simply means the laboratory was not able to assess the cells to give a result. This may be because of the presence of blood obscuring the cells, or because the sample of cells was too thick or thin. In 2010-11, the percentage of inadequate tests was 2.8 per cent.

Is cervical screening effective?
Whilst cervical screening cannot be 100 per cent effective, cervical screening programmes have been shown to reduce the incidence of cancer in a population of women. For example:

Percentage of Cancer Preventable
(Protection offered by a single negative smear)

Coverage of the target population

The NHS Breast Screening Programme currently saves an estimated 1,400 lives each year in England. If you receive an appointment letter now or in the future, please don’t miss out on this important opportunity.

For more information or for women over 73 who wish to book a screening appointment tel: 0161 291 4444 or visit the website www.breast-screening.uhsm.nhs.uk

New Resources for Manchester Breast Screening programme are now available:

Breast Screening Leaflet	Updated: 17/02/12	192KB
Breast Screening Poster	Updated: 17/02/12	96KB
Breast Screening Patients Poster	Updated: 17/02/12	96KB

As part of this year’s Cancer Prevention Week 14 – 18 May 2012 the Public Health Development Service is promoting healthy living and greater awareness of the signs and symptoms of cancer.

For a host of information on a healthy diet, physical activity and maintaining a healthy weight visit www.gettingmanchestermoving.org.

Smoking is a big cause of cancer, for more information and advice visit
www.stopsmokingmanchester.co.uk. For support to quitcontact us by clicking here.

Cancer Champions can provide information and advice about symptoms and early diagnosis of the disease. They are also available to give free presentations of any lengths to groups across the city.

Click on the PDF below to find out more:

Press Release

Updated: 15/05/12

480KB

A record number of Cancer Champions have been trained in Manchester to raise awareness of the signs and symptoms of kidney and bladder cancer in a new campaign: ‘Be Clear on Cancer’. Manchester Mental Health and Social Care Trust now has 30 Cancer Champions trained up, considerably more than other boroughs in Greater Manchester.

Click on the PDF below to find out more:

Press Release

Updated: 17/02/12

352KB

Following the death of Jade Goody in March 2009, we have had a lot of enquiries and questions asking about the reasons why women under 25 are NOT invited or can (in most circumstances) access regular cervical screening which is also known as smear testing

This is because changes in the young cervix are normal. If they were thought to be abnormal this could lead to unnecessary treatment which could have consequences for women's childbearing. Any abnormal changes can be easily picked up and treated from the age of 25. Rarely, younger women experience symptoms such as unexpected bleeding or bleeding after intercourse. In this case they should see their GP for advice.

In June 2009 the Advisory Committee on Cervical Screening reviewed the policy of starting screening at age 25 and agreed unanimously there should be no change in the current policy.

The ‘Don’t be a cancer chancer’ campaign has been designed to promote greater awareness of the signs of 3 major cancers – lung, breast and bowel.

The figures available to us illustrate the devastating effect cancer can have on people and how early detection can be the difference between life and death.

Cancer is a disease which can grow and spread and it is this progression which can make it more difficult to cure. The longer you leave it, the stronger it will become, and the harder it is to defeat.

• One in three people will develop cancer - and one in four people will die from cancer
  
• About 15,000 people across Greater Manchester develop cancer each year
  
• About 7,000 people in Greater Manchester will die each year from cancer.

Focusing on early detection, rather than smoking or diet
Good work is already taking place to address cancer prevention such as smoking cessation and healthy eating but this campaign specifically focuses on early diagnosis. For the three most common cancers, early detection is known to have the following effects on survival:

• For bowel cancer, you are almost twice as likely to be cured if it is spotted early
• For lung cancer, you are three times as likely to be cured if caught before the cancer spreads
• 95% of breast cancer patients are cured if their cancer is spotted early and has not spread
• 80% of patients who have breast cancer can be cured even the cancer has spread but this figure falls dramatically if the cancer spreads further

The Campaign
The campaign will run across Manchester in March and April 2009 to encourage people to self-check. We are doing everything we can to help people recognise symptoms and act appropriately by encouraging them to see their GP as early as possible.

The campaign aims to communicate to people the signs they should look out for and what to do (see a doctor) in a very simple, straightforward way.
The campaign is aimed at the over 50’s and a number of tactics are being used to intensely target areas where there are more people over 50 and where we know people tend to delay visiting their GP, even if they have symptoms.
With help from supporters of the campaign, materials will be distributed across Manchester from week commencing 23rd March 2009. People will see advertising and receive information via door-to-door leafleting, posters sited at the roadside and on large billboards. Materials will be distributed throughout the local community in GP surgeries, pharmacies, shops, launderettes, bingo halls and libraries. We will reach the public in the pub, the street and even in the hairdressers.
The local press will also be publicising the campaign; so we trust that the all-important messages will not be missed.

• See the campaign resources here