Why the smear test needs a digital makeover

If all eligible women had a smear test, around 83% of cervical cancer deaths could be prevented. The test screens for changes in the cervix that may lead to cancer. We know it saves lives. That’s the good news. The bad news: uptake has plummeted to a hugely concerning 20-year low.

Although quick and simple, the latest data shows that many fear the procedure will be uncomfortable and embarrassing, with too many barriers to access. This is the most common cancer in women under 35 in the UK and something needs to change. These changes don’t need to be tough, we just need to embrace the latest technology.

Every three years every woman aged 25 to 49 gets a letter through the post inviting them to book a smear test with their GP. Women aged 50 to 64 are invited every five years. But 1 in 4 women skip screening. For some groups, these figures are worse: only 1 in 3 aged 25–29 attend screening and this drops to 1 in 2 in deprived areas.

Clearly the smear test needs some good PR and an image overhaul. This is a focus of the NHS 10-year plan, which also calls for greater use of the latest technology. There is a concern that some groups will be disconnected. However, for each demographic there are different issues, which require targeted approaches.

The tech-savvy young women who are shunning smears are generally considered to be the healthy ones. The most common reason for non-attendance is “intending to, but not getting round to it”. So how can the tech of Candy Crush and selfies make a difference?

First, lets get rid of the post. These young women are used to pings, notifications and emails — let’s make sure they’re paying attention by talking to them in the way they’re used to.

Second, the current booking system is antiquated. Following the letter invite, women must call their GP to book, an often-frustrating and drawn-out process. Many GP practices have long waits and offer screening on restricted days and times. A digital-first approach can remove barriers to accessing screening. So let’s make it as easy as possible to book with online, in-app appointments that can be made at convenient times and locations. The invitation could have videos, explorable infographics and links to useful information. It could all be animated, with a virtual walk-through showing exactly what happens and addressing common concerns. Or even better, push for at home self-testing kits (currently being evaluated) that can be ordered online and sent back.

Women could be contacted electronically if they have not booked an appointment to re-engage and discuss their personal barriers to attendance. Simple queries could be managed by intelligent chatbots or women could be given the option to access a five-minute pre-appointment virtually to discuss their concerns with a health professional. Giving women easy, digital access to their health records should enable greater ownership. Women could check their own records following these campaigns and be self-empowered to book an appointment.

But it’s not just the ease of access that is the issue. Women don’t attend screening for a variety of reasons. Research by Jo’s Cervical Cancer Trust revealed that many women are not aware of the importance of screening. More than a third believe screening does not reduce their cancer risk and a quarter believe they do not need to attend because they are healthy.

These perceptions need to be challenged. The smear test should be a routine but necessary part of every woman’s life. We now have the ability to raise awareness by targeting different groups of women via social and other online media. We should focus on frequent non-attenders with creative campaigns targeted to these specific demographics.

Social media can be a force for good and play a huge role. Social marketing campaigns, such as #smearforsmear can massively raise awareness and self-engagement.

We know this works. It is ten years since Jade Goody publically shared her diagnosis of cervical cancer, which sadly claimed her life. Around half-a-million extra screening attendances were made during this time; at peak coverage, attendance was 70% higher than expected.

We should not have to wait for another high profile individual to lose their life to this preventable disease. The organisation I work for, Babylon, has worked with well-known influencers to raise the profile of screening, dispel myths and relay positive personal experiences. But this should be something we’re all talking about. We should be encouraging friends and family that this is like the dentist — something we do for future health, that it may be uncomfortable and embarrassing but that it really matters.

Digital-first GP services, such as Babylon’s GP at Hand, are well positioned to tackle these issues in novel ways. It is a challenge to make physical screening work in a digital-first world where users expect slick, on-demand services. There is lots that can be done — and really it must be done. 900 women die of cervical cancer each year in the UK. Most of these deaths are preventable.