Hansard

I, too, thank Ken Macintosh for his opening remarks and for bringing this debate to the chamber, and I thank members for their constructive contributions on this important issue.

I am happy to agree to Ken Macintosh's request to draw this debate to the attention of the JCVI before its next meeting and to ensure that it is aware of members' views on this important issue.

As we have heard, cervical cancer is the second most common cancer that affects women. In almost all cases it is caused by a family of viruses called human papilloma viruses. HPV infection happens, as a matter of course, as a result of sexual activity. In most women, HPV causes no long-term harm, but some women are at risk of developing cancer without showing any physical signs of infection.

In that context, the first thing to say about protecting women's health is that the cervical cancer screening programme offers the best protection available to women. We know that if cervical cancer is identified early, treatment can be delivered quickly and survival rates will continue to improve. That is why, although it is important to have a debate about vaccination, it is also important to encourage every woman to take up her invitation to attend for screening. I am grateful to Nanette Milne for reminding us of the pioneering work that was done by Betty Macgregor and her colleagues in Aberdeen. We want to maintain that reputation for leading the way in this area, so we will continue to build on the success of the cervical cancer screening programme in Scotland.

Although Ken Macintosh and other members rightly drew attention to some negative trends, it is also important to recognise as part of the big picture that deaths from cervical cancer declined by 30 per cent between 1995 and 2005, and that the incidence of the disease between 1986 and 2003 fell by 45 per cent. Those trends are significant and positive. The five-year survival rate for cervical cancer is now 70 per cent, compared with only 54 per cent in 1981. All those positive trends reflect clearly the benefits of early diagnosis through cervical screening, which is key to our continuing approach to dealing with the disease.

NHS Quality Improvement Scotland reviewed the cervical screening programme last year and praised it for delivering "extremely high quality care." The national uptake target was set at 80 per cent. The level of uptake is still above that target but, equally, as members have said, there has been a slight decline in recent years. That concerns us, and we recognise that action is required. A number of members have asked us to take and support such action.

We have in place a national advisory group on cervical screening, which is closely monitoring uptake rates and will provide advice as appropriate to the Executive and NHS boards on strategies for increasing uptake. NHS boards have a duty continually to assess the needs of their local communities and to target groups in their areas where that is appropriate to increase uptake, particularly, as has been said, among younger women, certain ethnic minority groups and women with learning disabilities.

There are some good examples of local initiatives to tackle low uptake. For example, NHS Lanarkshire is piloting a community health education programme that is focused on deprived areas, and is also working with local learning disability services to improve the uptake of cervical screening. In Fife, women who do not attend screening are issued with leaflets that provide information on their choices as to where they might attend for treatment. The healthy women's project in Lothian is doing similar work. There are other examples throughout Scotland.