From inhibitions about the appearance and smell of the vagina to a fear of being judged as sexually promiscuous, women are putting off having smear tests due to perceived stigma, with young women the most likely to skip smear tests. Here’s why greater awareness and education is so vital

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Let’s start with some stark facts: of the five million women invited for smear tests in the UK, one in four of us will not attend (in Glasgow, it’s one in three in the 25-29 age group). Despite the fact that early identification of pre-cancerous cells dramatically improves survival rates, gynaecological cancers have some of the worst outcomes for women according to Helena Morrissey, chairman of The Eve Appeal, with a 40 per cent mortality rate. If attending smear tests and reporting unusual gynaecological symptoms to a GP is key to saving lives, why are so many of us shying away from screening and seeking help?

The reasons are many and complex, but a recent survey of 2,017 women by Jo’s Cervical Cancer Trust highlighted that young women in particular are skipping smear tests (which can prevent up to 75 per cent of cervical cancers) due to embarassment. Despite the fact that cervical cancer is the most common form of cancer in women under the age of 35 , 35 per cent of young women avoid smear tests due to feeling ashamed of their body, with 34 per cent missing appointments owing to the shape of their vulva and 38 per cent skipping screening as they’re concerned about the smell of their vaginal area. A third reported that they wouldn’t go for a smear test if they hadn’t waxed or shaved.

Not only are young women most likely to avoid cervical screening due to embarrassment, but they’re also the group most likely to avoid discussing gynaecological health, despite an oft assumed air of openness among young people. According to a survey conducted by The Eve Appeal, less than 25 per cent of women aged 16-25 feel confident raising or talking about topics related to gynaecological health, with 65 per cent feeling uncomfortable using words such as ‘vagina’ and ‘vulva’. It’s not just a gynaecological language barrier that we’re facing either- just half of women aged 26-35 can correctly identify the vagina on an anatomical diagram, compared to a generally better educated and informed older population- 80 per cent of women aged 66-75 know where the ovaries are located and 90 per cent can correctly identify the womb. This, despite a view held by 60 per cent of those surveyed that young women are more aware and informed about gynaecological health, and 75 per cent perceiving that young women find it easier to talk openly on the topic.

In fact, while one in ten women aged 16-35 admitted that they struggled to talk to GPs and health professionals about gynaecological health concerns, even more would avoid making an appointment at all- a third reported that they wouldn’t go to the doctors for gynaecological issues out of embarrassment. Possibly even more concerning, The Eve Appeal also reports that one in five women associate gynaecological cancers with sexual promiscuity, with a quarter of us avoiding key tests or having symptoms checked out of a fear of being judged as sexually promiscuous, or anxiety over discussing our sexual history.

Education and greater awareness are essential for spotting signs and symptoms of gynaecological cancers, which aren’t limited to cervical cancer. Womb, ovarian, vaginal, vulval and cervical cancers make up the five gynaecological cancers, and while many share symptoms, some have less common or obvious markers- visit The Eve Appeal website  to find out more information about the symptoms, diagnosis and treatment of all five cancers. Also, Morrissey encourages us not to underestimate the power and potential of frank, forthright and honest discussion:

“Understanding the symptoms will save lives, which is why we are urging women this to talk more openly about these life-saving issues.

At the Eve Appeal we know how important it is to promote straight talking about the signs and symptoms of gynaecological cancers to women of all ages, and this survey has highlighted just how far we still have to go to make this happen."

Given that 51 per cent of women feel happy and comfortable discussing gynaecological issues with female friends, and 34 per cent with a sister, starting vital conversations at home could be instrumental in the sharing of knowledge and experience, but it’s time we erased the shame and started speaking up, and turning up, without fear, embarrassment or judgement. As Robert Music of Jo’s Cervical Cancer Trust implores, “please don't let unhappiness or uncertainty about your body stop you from attending what could be a life-saving test.”

There's no better time than now either- this week marks Cervical Cancer Awareness Week in the UK, with charities and brands such as Hanx , a condom range designed for women with 'eliminating stigma' as a key company mission statement, putting topics related to the disease firmly on the agenda. Hanx in particular are focusing on the importance of young women getting the HPV (human papilloma virus) vaccination  between the ages of 11-18, as HPV is implicated in 99.7 per cent of cervical cancer cases, and three of the five gynaecological cancers in all.

Got smear fear? Here’s how to conquer it

For support, information and resources, visit  The Eve Appeal  and  Jo’s Cervical Cancer Trust website

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