HSE CervicalCheck initiatives improving access to screening for more women

Marking Cervical Cancer Prevention Week (20 January – 26 January), the HSE’s CervicalCheck programme is highlighting how screening is now even more accessible to all eligible women.

The most effective action women aged 25 to 65 can take to prevent cervical cancer is to #ChooseScreening and come for follow-up appointments if advised. Women can go to any GP practice or clinic registered with CervicalCheck for their free screening test. Women do not need to be registered with a GP practice to request a screening test from them.

More than 4,000 healthcare professionals across the country provide CervicalCheck screening across a range of community and healthcare settings, including some of Ireland’s Sexual Assault Treatment Units (SATUs) and Limerick Female Prison.

Connie McGilloway is an Advanced Nurse Practitioner and Forensic Clinical Examiner at the Donegal Sexual Assault Treatment Unit (SATU) in Letterkenny. Connie developed a trauma-informed cervical screening follow-up clinic in the SATU after noticing many women attending the unit had never been screened or weren’t up to date with their appointments.

Connie said: “Since 2017, our SATU follow-up clinic has been providing cervical screening to women in a trauma-informed, non-judgmental environment where they feel safe. Our work is supported by CervicalCheck and Letterkenny University Hospital gynaecological service.

“When we discuss screening, some women talk about feeling embarrassment, shame and guilt related to their experiences; or they are fearful they will have to talk about the abuse with their GP or practice nurse. But by far the most common reason for not having a screening test was related to the nature of the test itself. For a woman who has suffered some form of unwanted sexual contact, the trauma of that intimate examination can be overwhelming.

“We consider everything from how we touch the woman to the words we use, and offer flexible appointment times after college or work. We give more time for the test, going at the woman’s pace, gaining her consent for every step to share control of what happens and when.

“The need for the service is reflected in the fact that we have a higher-than-average number of women who have a subsequent referral for follow up in colposcopy. The reason for that could be lack of early detection, the fact they haven’t had a test before. Women tell us afterwards if they knew they would be looked after that way during the test they would’ve had one earlier.”

Edel Muldowney is Chief Nurse Officer in Limerick Female Prison, a closed, medium-security prison. It is the second largest female prison in Ireland. Edel spearheaded an initiative to offer cervical screening onsite in the prison.

Edel said: “Up until 2023 the medical wing was shared with the male population so it was more difficult to offer women gender-based healthcare. Our medical team didn’t include a trained CervicalCheck sample taker, so if women wanted cervical screening they were escorted to a GP practice by 2 or 3 guards. Understandably, a lot of women declined.

“The new building was designed to support trauma-informed healthcare and its opening coincided with the appointment of a female GP.  We were also supported by a consultant gynaecologist, who offered expertise on what we needed to set up cervical screening inside the prison. Our nurses were trained by the team from CervicalCheck’s Screening Training Unit. Initially, I ran a screening clinic twice a month. Now our GP runs a Well Woman clinic one day a week alongside the GP service, offering screening, contraception and menopause advice.

“Before Christmas, we had three referrals for follow-up tests, a high number for such a small population but there are factors which might increase the risk for many of these women including homelessness, living with domestic violence, sex work, sexual trauma, they’re not used to really prioritising their health.

“We’re starting from scratch with some women, they have so much on their minds, and trauma can lead to resistance. Many are also managing addiction which is a challenge. I’m very grateful to the CervicalCheck team here in Limerick, who continue to support us. I know we’re having a positive impact for the women in Limerick Prison.”

Professor Nóirín Russell, CervicalCheck Clinical Director, HSE National Screening Service, said: “Cervical screening is the most effective ways to prevent cervical cancer in women. Through screening we can find and treat pre-cancerous changes in the cervix. For women who have cancer diagnosed through screening it is usually at an earlier stage when treatment outcomes are more likely to be successful. These access initiatives demonstrate how the National Screening Service is working to increase equity by overcoming barriers that prevent women from getting screened.

“Thanks to Edel and Connie’s expertise and commitment, more women are benefiting from trauma-informed healthcare. We want to support all women to have the benefits cervical screening offers by identifying and reducing the factors that stop them attending. We are particularly interested in initiatives that reach out to marginalised women as we know that nearly half of all cervical cancers are diagnosed in women who never attend for screening. Reaching these women and helping reduce barriers will help drive us towards Ireland’s goal of eliminating cancer in every community by 2040.”

CervicalCheck offers HPV cervical screening every three years to women and people with a cervix aged 25 to 29; and every five years to those aged 30 to 65 years. Cervical screening is for women who do not have any symptoms of cervical cancer. Never ignore symptoms of cervical cancer, speak to your GP, even if you have had a recent normal screening result.

Information about cervical screening and to check you’re on the cervical screening register.

Call Freephone 1800 55 45 45

Contact info@cervicalcheck.ie