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City Women Risk Death By Refusing Smear Tests Patients From Ethnic Groups and Deprived Areas Worst Off

Posted on: Monday, 21 November 2005, 12:00 CST

By JOHN McCANN Health Reporter

WOMEN in Glasgow risk developing cervical cancer because they refuse to have smear tests.

In2003, 16 women in Glasgow died from the disease even though death rates have shown a steady decline for several years.

But doctors are worried too many women remain at risk because they do not have a routine test or fail to attend a follow-up clinic when there are warning signs they may have a problem.

And the poorest women are most at risk.

Linda de Caestecker, acting public health director at NHS Greater Glasgow, said: "We have a target of seeing at least 80-per cent in a 5.5 year period.

"Uptake among women aged 20 to 60 is 82-per cent overall, but this varies with deprivation.

"We see more than 90-per cent of women in the leastdeprived areas, while in the most-deprived areas the figure is 79-per cent."

Dr Mar Soler-Lopez, who co-ordinates screening, said there had also been an increase in the number of women who failed to keep appointments for follow up tests or treatment.

This could prevent them from getting the allclear, or vital early treatment that could prevent them from developing cancer.

The latest figures show 3483 appointments at colposcopy clinics, a third of the total, resulted in a patient not turning up.

There are concerns some patients don't understand letters asking them to attend the clinics.

Women whose abnormal smears show they are at the most dangerous stage before cancer are told it is "almost certain to be minor and not cancer". Those who have cells which show milder warning signs are told their smear shows "dyskaryosis". The word "cancer" does not appear on their letters.

Tracey Williams, information nurse with CancerBACUP said: "It is important that information about follow-up appointments is in clear and simple language so women understand why they are being asked back and why it's important they attend.

"But alarmist language should be avoided - it could have the reverse effect and frighten women away from services."

Dr de Caestecker said:

"Our letters follow research on what works best and the worst thing you could do would be to tell someone they had cancer when they hadn't."

Dr Soler-Lopez said some women in deprived areas are so caught up in other issues that they set aside appointments while many struggle to find and afford childcare to allow them to go to a clinic.

Women from among ethnic minorities where cultural concerns can be an issue are poor attenders because they may have less understanding of the importance of screening and early treatment.

The health board is working with GPs to make sure that female staff are available to carry out tests to avoid embarrassment and improve attendance rates for smears.

john. mccann@ eveningtimes. co. uk

Source: Evening Times; Glasgow (UK)

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