Campaigners are calling for a public awareness campaign to encourage more women to go for routine cervical screening after numbers attending appointments in England fell to their lowest level in two decades.

East Anglian Daily Times: Becky Marsh with her son, William, six. Photo: Becky Marsh, contribted.Becky Marsh with her son, William, six. Photo: Becky Marsh, contribted. (Image: Archant)

They say that unless action is taken more mothers, daughters, sisters and friends will be lost.

Leading charity Jo's Cervical Cancer Trust says the situation across East Anglia mirrors the national picture, which shows coverage among 25 to 64-year-olds in England has fallen from 72.7% to 72% in the last year, with more than 1.2 million women not taking up a screening invitation. It is now the lowest it has been for 20 years.

In Suffolk, overall coverage is down from 74.5% to 74.1%, dropping to 72.2% among 25-49-year-olds, below the East of England average of 73.3%. In Essex coverage is 74.7%, down from 75.1%, falling to 73% in the 25-49 age range while in Norfolk it's 74.4%, down from 74.8% and 72.8% among those aged 25-49.

The charity is further concerned that only 71.6% of women receive their cervical screening results within two weeks, far below the national target of 98.1% and a huge drop from 89.1% the year before.

East Anglian Daily Times: Cervical screening can pick up abnormalities which, if not treated, can lead to cancer. Photo: Bill Smith .Cervical screening can pick up abnormalities which, if not treated, can lead to cancer. Photo: Bill Smith . (Image: EDP pics � 2003)

Every day nine women are diagnosed with cervical cancer and two die but screening is estimated to save around 4,000 lives annually. Almost all (99.7%) of cervical cancers are caused by persistent human papillomavirus (HPV) infection, which causes changes to cervical cells. Anyone who is sexually active is at risk of contracting genital HPV and teenage girls are now routinely vaccinated against the virus.

Becky Marsh is one of those 4,000 women whose lives are saved every year by cervical screening.

The 38-year-old, who lives near Beccles and is mum to William, six, has always taken up three-yearly NHS routine screening invitations and her results had never been anything to worry about until 2014, when abnormal cells were detected. In fact, says Becky, there were 'severe' changes.

Further tests showed she had 'micro-invasive', or early-stage cancer. Treatment was a Lletz, or 'loop', procedure, where a small wire loop with an electrical current running through it cuts away affected tissue and seals the wound at the same time. Further tests after treatment came back clear and Becky is now having yearly check-ups.

'I had no symptoms whatsoever before that routine smear test in 2014 and without it wouldn't have known I had cancer until a later stage, when it would have been much more serious and difficult to treat,' she says. 'I didn't have to have chemotherapy or radiotherapy because my problems were discovered early. I dread to think what would have happened if I hadn't gone for that appointment in 2014. Just a year later and I could have ended up having a hysterectomy and lost the chance to have any more children.

'My experience shows just how important routine screening is and why I would always advise women to go. It's free and takes just a few minutes. But it can save your life.'

Jo's Cervical Cancer Trust chief executive Robert Music says he is extremely disappointed but not surprised by the latest NHS statistics, published last week.

'We have spoken out time and time again about the need for investment and action to improve cervical screening attendance, but this is simply not happening,' he said. 'The Cancer Strategy for England emphasises prevention so it is incredibly frustrating to see lack of activity to increase participation in a programme that can prevent diagnoses of cervical cancer.

'We should be proud of our cervical screening programme. It saves thousands of lives every year and further developments such as the introduction of HPV primary screening are only going to make it better. However with increasing numbers not attending fewer will benefit from these improvements. As a charity we are working our hardest but we can't do it alone. There are some examples of amazing work happening across the country to improve uptake and we need to see this amplified, or lives will be lost. These statistics must surely serve as a call to action to make the screening programme more accessible.'

The charity is calling a government-funded national awareness campaign and investment. It says a lack of funding is hindering changes that would allow women to attend screening at a location of their choice, such as close to work, and to be able to self sample.

A report by the trust in January 2017, found almost half of local authorities and almost two thirds of CCGs (Clinical Commissioning Groups) had not undertaken any activities to increase screening attendance in the last two years, with many stating it was not their responsibility.

For more information visit www.jostrust.org.uk.

The 'Jade Goody effect' has gone

Reality TV star Jade Goody revealed she had cervical cancer in 2008 and died the following year, aged just 27.

The publicity surrounding her treatment and death led to a surge in the number of women going for routine cervical screening appointments.

Dubbed 'the Jade Goody effect' the surge was mainly made up of young women.

A study published in the Journal of Medical Screening in 2012 confirmed more than 400,000 extra cervical screening appointment attendances were recorded in England between mid-2008 and mid-2009 - the period during which Jade Goody was diagnosed and died of cervical cancer.

An increase in screening attendances was observed at all ages, though the biggest rise was for women aged under 50. For the 25-29 age group, there were an estimated 31,000 extra screening attendances over five months between autumn 2008 and spring 2009.

Robert Music, chief executive of Jo's Cervical Cancer Trust, says the latest NHS figures show 'the Jade Goody effect is long gone'.

About cervical cancer

Most (99.7%) cervical cancers are caused by persistent genital human papillomavirus (HPV) infection, which causes cell changes. Anyone who has ever been sexually active is at risk of contracting HPV

Around 13 high-risk types of HPV are responsible for causing cervical cancers, types 16 and 18 are the most prevalent, causing over 70% of cervical cancers.

Four out of five women are infected with genital HPV at some point in their lives without ever knowing - HPV is usually cleared (without treatment) by the body's immune system, with 80% of cells healing within two years.

A small percentage of women do not clear the infection and it can remain 'dormant' (inactive) or persistent, sometimes for years. If your immune system doesn't clear the infection and/or abnormal cells are not removed or monitored, cancer can develop. This is why cervical screening and HPV vaccination are important in helping to spot abnormalities and prevent cancer

Research has shown that changes in abnormalities do not usually escalate quickly and it can take between five and 20 years for a cancer to develop.

More than 3,000 women are diagnosed with cervical cancer and 200,000 with cervical abnormalities each year in the UK

Women aged 25-49 are invited for cervical screening every three years and from 50-64 every five years. The percentage of results showing a high-grade abnormality decreases with age and was highest, at 2.7%, for women aged 25-29, falling to less than 0.5% for women aged 50 to 64.