Dr Edana Minghella took to Twitter to share a problematic letter she received after she missed a smear test – and added her own suggestion for an alternative.
Over the last year, we’ve seen an important conversation bubble up from the depths of society: the importance of getting a regular smear test. Thanks to the publication of alarming statistics from Jo’s Cervical Cancer Trust and celebrities like Zoella (Zoe Sugg) and Michelle Keegan joining the conversation, we’re more aware than ever of the importance of getting young women to attend their screenings.
And that’s what makes the language we use when talking about smear tests so important – especially when you learn that cervical cancer is the most common form of cancer in women under the age of 35.
So, understandably, when Dr Edana Minghella received a letter from her primary care service notifying her that she had missed her recent smear test, she was shocked by how black-and-white the letter made the issue seem.
“I’m sharing this because I know I’m not the only one. Dear primary care services, please think about how you communicate with women about #cervicalscreening,” she wrote.
Below the tweet Dr Minghella attached two images – one of the letter she had been sent, and one with some changes she thought needed to be made.
The first letter, which detailed Dr Minghella’s failure to “respond to invitations” for her routine screening, did succeed in advising that smear tests can “significantly reduce the risk of developing cervical cancer,” the letter didn’t take a very sympathetic tone when it came to addressing her future tests.
“If you do not wish to take part in the national screening programme you will need to fill in a disclaimer to this effect,” the letter’s concluding paragraph read. “You may request the disclaimer from the practice. Once completed and returned your medical records and the national screening programme will be updated.”
In her edited letter, Dr Minghella took it upon herself to make the address more personal and understanding – and that started with the way the letter opens.
“Dear Edana,” the edited letter began, contrasting with the “Ms Minghella” of the original address. “We are sorry you haven’t felt able to take up the Cervical Screening Team’s invitations to attend for screening.
“We would like to encourage you to attend, but we do understand that many women find the screening difficult or painful for all sorts of reasons,” the edited letter continued. “If you would like to talk in confidence to a doctor or nurse about how we can help make the procedure as painless and as psychologically safe for you as possible, please do get in touch so we can arrange an appointment.”
When some of the latest statistics from Jo’s Cervical Cancer Trust revealed that women who delay or don’t go for cervical screening feel scared (71%) and vulnerable (75%) at the thought of going, the language used to follow-up on this absence is clearly incredibly important.
There are a whole variety of reasons why women might feel inclined to delay or simply not respond to a smear test invitation. For example, 37% of the women who spoke to Jo’s Cervical Cancer Trust said one of the major reasons why they would delay or miss a test was simply because they did not know what will happen during the screening process.
And for some women, smear tests are also near impossible. Two thirds of women with a physical disability have been unable to attend a cervical screening appointment because of their disability, according to Jo’s Cervical Cancer Trust. Furthermore, only 19% of women with learning disabilities have had a recent cervical screening, compared to 73% of the general population, report Dimensions, a charity that supports people with learning difficulties.
Cervical screening can also be an incredibly traumatic experience for survivors of sexual assault, for obvious reasons. That’s why specialist projects like Pavan Amara’s My Body Back clinics – which allow victims of assault to receive vital sexual health services, including maternal care, STI testing, contraceptive care and, importantly, smear tests – are so important in raising awareness of the problem.
“It is a hidden issue because when women experience sexual assault, they already don’t want to talk about it,” Amara previously told Stylist. “Sexual assault silences women.”
While the needs of women across the country obviously vary on a case by case basis, it’s important conversations such as the one sparked by Dr Minghella’s post that can make a difference in increasing accessibility to testing. As at-home DIY smear test kits become available to a select-group of women under a London pilot-scheme this month, there’s hope on the horizon for anyone who finds cervical screening a difficult or challenging prospect.
If you have received an invitation for a smear test with your local GP and haven’t yet booked one, it’s highly recommended that you do so as soon as possible. Worries and concerns are normal, but they shouldn’t prevent you from attending a screening.
Still feeling anxious? We put the most common questions about smear tests to a doctor – and her answers were truly reassuring. You can check them out here.