Hansard

I thank my good friend and colleague Ruth Maguire for raising this issue in the chamber today and for sharing her personal experience. I also thank colleagues for their important speeches.

Raising awareness of cervical cancer prevention is absolutely crucial if we are truly to achieve prevention of this disease. We have a unique and exciting opportunity to entirely eradicate a cancer that affects so many, and I am determined that we do all that we can to achieve that.

There are a few different aspects that work together to help us to prevent cervical cancer. As outlined in the motion, the World Health Organization has identified three key targets that will move us towards eliminating this disease. I am working very closely with my officials on progressing work in relation to the WHO targets for screening, the HPV vaccine and treatment.

Cervical screening is key to ensuring that those who are developing the cancer are treated as early as possible, whether that is at an early stage of cancer or even at the point of identifying pre-cancerous cells. As I often reiterate, this is the one screening test that catches cancer before it is even cancer. The World Health Organization target is for 70 per cent of women to be screened using a high-performance test by the age of 35 and again by the age of 45. In Scotland overall, screening uptake is consistently above 70 per cent in women in the 35 to 44 and 45 to 49 age groups. However, as many members have mentioned, screening uptake is below 70 per cent in younger age groups and among women in the two lowest quintiles of the Scottish index of multiple deprivation. That is not good enough.

It is not enough for us to meet the World Health Organization targets at general population level. We must work to ensure that we meet the targets for the whole population. One of my top priorities for the screening programme is to continue to increase overall uptake but also to reduce inequalities. As we all know, the factors that drive inequality are complex and defy easy solutions, but I am passionately committed to closing the gap and so, too, is the screening community in Scotland.

We have awarded £456,000 to Jo’s Cervical Cancer Trust to support its vital campaign work on cervical cancer. That includes work to raise awareness of screening benefits and to tackle and understand key issues around access and uptake. This month, we have worked with Public Health Scotland to support other partners to promote cervical cancer prevention week.

For all the cancer screening programmes, we have committed £2 million over the past two years to take a more sustainable and systematic approach to reducing inequalities. That has empowered health boards to take action at a local level to meet the needs of specific populations. Nationally, it has supported improvements in communication with screening participants and the collection and analysis of data so that interventions can be better tailored for maximum impact. These inequalities are driven by complex factors, and work is on-going to develop a long-term strategy to address those.

All members in the chamber will be aware that there has not yet been a recommendation on cervical self-sampling from the UK National Screening Committee. However, in Scotland, we continue to lay the groundwork for introducing cervical self-sampling, which has the potential to remove some of the barriers that can deter people from attending for screening. That is a complex undertaking, and we are awaiting—not very patiently, I agree—consensus on the most appropriate test and how to use it. I see a lot of potential benefits to it. One very powerful example of that benefit is that victims of sexual violence could carry out self-sampling in the safe environment of their own homes. We are doing all that we can to ensure that we will be able to respond quickly to the NSC advice once it is published.

Of course, cervical self-screening is not the entire solution. We already have home screening kits for bowel cancer and we do not get 100 per cent participation, so although self-screening is a very important step forward, it is not the entire solution. The inequalities project produced some key findings on cervical screening. Methods that are successful in increasing uptake include using locations that feel safe, familiar and convenient, and targeting defaulters, which is what self-sampling pilot schemes look to do, is an important part of that work. Flexibility in delivery is also important. If we continue with cervical screening at GP practices, what about providing out-of-hours clinics?