Women who missed smear test in pandemic ‘seven times more likely to develop cervical cancer’

Women who missed their smear test due to the pandemic may be up to seven times more likely to develop cervical cancer, research suggests. 

The NHS encourages all women aged 25 to 49 to get screened for cervical cancer every three years, and all those aged 50 to 64 every five years. 

It’s unclear exactly how many women have missed their appointments since Covid struck nine months ago, but there are fears it could be hundreds of thousands.

King’s College London experts modelled two different scenarios in an attempt to calculate the true toll of the pandemic on the disease.  

The first saw all women eligible for screening – more than 10million women – have their tests delayed by six months. The Cancer Research UK-funded study found for every 100,000 women screened after the half-year delay, 5.9 extra cervical cancers were estimated.

The second scenario modelled what would happen if half of women who were due for a cervical screening during 2020 (750,000) had to skip tests entirely and wait for their next appointment either three or five years down the line.

In this scenario, there were 41.5 extra cervical cancers per 100,000 women, a seven-fold increased risk compared with scenario one.  

When detected at an early stage, more than nine in 10 women beat cervical cancer. But the survival rate is slashed in half when the disease spreads around the body.

Women who miss cervical cancer screening appointments could be up to seven-times more likely to suffer from the condition, research suggests. (stock)


Cervical cancer affects the lining of the lower part of womb.

The most common symptom is unusual bleeding, such as between periods, during sex or after the menopause, but other signs can include:

  • Pain during sex
  • Vaginal discharge that smells 
  • Pain in the pelvis

Causes can include:

  • Age – more than half of sufferers are under 45
  • HPV infection – which affects most people at some point in their lives
  • Smoking – responsible for 21 per cent of cases
  • Contraceptive pill – linked to 10 per cent of cases
  • Having children
  • Family history of cervical or other types of cancer, like vagina

Source: Cancer Research UK 


Almost a quarter of a million women are overdue their smear test, NHS figures have suggested. 

Some 3.2million women in England have been screened for the cancer in the last 12 months, down 240,000 on the 3.43million checked last year.   

The NHS shut down the majority of its services in early March to free up beds for an influx of Covid-19 patients when the crisis started to spiral. It means millions of vital tests, appointments and operations were delayed. 

Even when services got back up and running over the summer, many patients were hesitant to use the NHS for fear of catching Covid or being a burden on the health service.

Cancer Research UK said more than 350,000 people who would normally have been urgently referred to a specialist to have vital tests to check if they have the disease have not been.

Scientists today called for more appointments to be made available to ensure women who were not screened for cervical cancer can still be checked within months. 

The cancer has no symptoms in the early stages, meaning it could spread to surrounding tissue before it is diagnosed.

But when spotted early and treated, the five-year survival rate for women is 92 per cent. This is slashed to 56 per cent if it is only found later.

Around 3,200 women are diagnosed with the disease every year, or eight every day, in the UK.  As many as 13,800 are identified annually in the US.

Experts from the Cancer Prevention Group at King’s College London modelled the impact of missed appointments in research published today on MedRxiv.

Despite the increased risk, they found the number of extra cancers would be the same in both groups – 630.

This was because the estimates in the first group were based on 750,000 women missing screening, while in the second 10.7million saw appointments delayed.

Writing in their paper, yet to be peer-reviewed, lead author Dr Alejandra Castanon, said: ‘To ensure equity for those affected by Covid-19-related screening delays, additional screening capacity will need to be paired with prioritising the screening of overdue women.’ 

Dr Castanon added: ‘Our research highlights the importance of women attending screening when they receive an invitation.

‘All efforts should be focused on measures that ensure that women feel confident to attend and do not miss an entire screening round on account of the Covid-19 disruption.’

Rachel Orritt, Cancer Research UK’s health information manager, said she encouraged all women who were due an appointment to get screened.

She added that those who were already experiencing symptoms – including pain in the pelvis and during sex – should call their GP.

Robert Music, the chief executive at Jo’s Cervical Cancer Trust, said: ‘It is understandable, however far from ideal, that there has been disruption to the cervical screening programme.

‘While services have resumed across much of the country, the focus must be on identifying areas where additional resources and support are needed.’

He added that the pandemic has left some women feeling there were ‘barriers’ to getting screening, particularly those in Black, Asian and minority communities. 

‘Cervical screening can prevent cervical cancer and campaigns and innovations to increase attendance will enable us to reduce diagnoses and save lives,’ he said.

‘If your GP invites you for screening, it is because they have put in safety measures to make it safe for you to attend.’ 

A spokesman for the NHS said: ‘Fortunately this study was based on assumptions that are unlikely, and it neglects to mention the fact cervical screening services are now back to normal, with hundreds of thousands of invites going out every month.

‘While the impact of any delay on patients who were due to be screened is extremely low, it is important to book an appointment to be screened if you are invited and as always, anyone with symptoms should contact their GP.’

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