Davies, Consultant Screening & Immunisation Lead, NHS
England/Pubic Health England gave a presentation on the benefits to
be achieved from screening programmes.
The uptake on screening services in Leicester was generally below
the national average.
the presentation Dr Davies commented that:-
screening programmes had false positive and false negative results,
and the effectiveness of any screening programme was to have low
numbers of both these false results.
Screening rates in Leicester were declining more rapidly than the
decline in the national average and were now 64.3% compared to the
Central Midlands rate of 72.9% and the national rate of 71.7%.
- The uptake
from younger women was lower than older women. There was now collaborative working between all
health agencies and providers to address this in Leicester by both
national and local publicity campaigns.
Locally, UHL was working actively with GP practices and offering
in-house and community clinics to improve the take up. In addition,
there was a student led social media campaign, local
business/community venues were being asked to display posters and
there was an active Don’t Fear the Smear campaign asking
women who have taken the test to take a selfie and post on their
social media account with the # and to tag 5 of their friends to
Traditionally, all smears were examined under a microscope and
those showing minor changes were then tested for human papilloma
virus (HPV), this was changing to all smears being tested for HPV
first and only those showing a positive result would be examined
under a microscope. This would enable
the number of test laboratories to be reduced from around 45 to
9. There would be one test laboratory
in the West Midlands and one in the East Midlands. UHL had not bid to be a test a laboratory and
mitigations would be put in place whilst people changed from one
test to the other and the new arrangements were fully
implemented. The new practice and
arrangements should be in place by the end of 2019.
Screening rates again lower than the national rate but whereas the
national rate had remained fairly static
over the last 8 years; the rate in Leicester had pronounced
fluctuations within it.
Leicester’s current rate was now 65.8% compared to the
Central Midlands’ rate of 73.9% and the national rate of
- The City
was divided into 3 areas for the 3-year screening programme and the
fluctuations in uptake were reasonably predicable depending upon
which part of the city was being screened each year.
Screening in Leicester showed men had a lower uptake but higher levels of positive results and
women had a higher uptake with lower levels of positive
- The test
was changing from April 2019 from one where 2 samples are taken on 3 separate occasions and
these are then sent in a sealed envelope for testing in a
laboratory; to one where a single sample is taken. It was felt that this would improve the uptake of
the test, especially in households with multiple occupants where an
individual may find embarrassment with storing the stool sample
card for 3 days in a bathroom shared with others.
In response to a question, Dr Davis commented that
the previous test for bowel cancer produced a higher than average
level of positive results resulting in a patient having a
colonoscopy. Projections showed that if
there was an 7% increase in the uptake of the new tests and the
forecast level of slightly lower positive results, then this would
have a negligible effect upon the number of colonoscopy procedures
carried out. A 10% increase in the
uptake could have an impact on the colonoscopy service.
Dr Davies was thanked for his