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Cervical Cancer in the UK

Research question

What policies and measures have been instituted in the UK to prevent and treat cervical cancer among adult women, how effective they are, and how can they be improved?

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Carrieri and Bilger (2013 p.543) have defined cervical cancer as “cancer of the entrance to the uterus (womb). The cervix is the narrow part of the lower uterus, often referred to as the neck of the womb”. The intraepithelial neoplasia and cancer of the cervix is predominantly found in adult women above the age of thirty and has been connected with the Human Papillomavirus (HPV), which is one the strongest epidemiologic risk factors (Bosch, Lorincz, Munoz, Meijer, & Shan 2002).

Cervical cancer is one of the most common diseases affecting women and has a significant amount of lethal outcomes. However, modern healthcare allows women to take steps to prevent cervical cancer, and if more attention is focused on the issue, new ways to improve the situation can be discovered.

In the UK, the government and other stakeholders have been actively introducing policies aimed at developing effective detection, diagnosis, treatment, and prevention mechanisms. These policies propose the methods that could prevent the disease before it even occurs (primary prevention) and reduce its impact if it had already occurred (secondary prevention), at the national, local, and personal levels (Wu 2008).

Since, in the past, a lot of research was focused on the secondary prevention methods, this study aims to conduct extensive research on the effectiveness of the policies and measures aimed at preventing cervical cancer among adult women altogether.

To answer the research question of this study, this paper will focus on policies and measures implemented by the government healthcare agency responsible for cervical cancer management. It will also analyze secondary data collected from journals, government sites, and other literature.

Background and Rationale

In the last twenty years, the diagnosis, treatment, and prevention of cervical cancer have notably developed in the UK as a result of the government’s active involvement with the issue. As a result of these measures policies, measures and generally improved healthcare research-based approaches, the amount of annual cases of this type of cancer has almost halved, going from 5,132 women in 1988, to 2,368 in 2008 (Cervical Cancer Incidence and Screening Coverage n.d.)

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1988 was an important year for the fight against cervical cancer because it marked the introduction of the first cancer screening program for women, which eventually evolved into the National Health Service (NHS) Cervical Screening Program, introduced by the government in 2015 as part of an overall Population Screening Program. Carrieri and Bilger described the cervical screening as “a method of preventing cancer by detecting and treating abnormalities of the cervix” (2014 p. 245).

Consequently, this is primarily a preventive policy, and its purpose is to fast track the process of screening adult women who are at risk of getting the type of cancer in question. The women aged 25-64 years are encouraged to attend free cervical cancer screenings in state-owned hospitals around the country. To increase awareness, the department managing cervical cancer develops documentaries and social advertising, and regularly alerts women through various means, about regular screenings. Under the policy, the women between the age of 25 and 49 are eligible for the screening every three years, and women aged 50 and above are invited every 5 years (Carrieri & Bilger 2013).

The effectiveness of this primary prevention program is monitored by the UK National Screening Committee (UK NSC), which has been mandated by the government with the duty of assessing the results and develops recommendations for the government. The main screening tests offered under the policy include cervical cytology and human papillomavirus.

Early cervical cytology is suggested as a quicker way of detecting cancer, but it is not always recommended due to the diagnosis delays which can lead to women being symptomatic before the results are produced (Landy, Castanon, Dudding, Lim, Hollingworth, Hamilton, & Sasieni 2015). In total, it has been estimated that, under current laws, more than 90% of adult women in Great Britain have reported undergoing a cervical smear or a mammogram, with only 2 to 4% never having had either (Moser, Patnick, & Beral 2009).

Using the above testing methods to examine the adult women in terms of their exposure to cervical cancer can lead to early detection, which increases the effectiveness of the treatment and increases the chances of a complete recovery of the patient.

Another vital policy that regulates treatment and prevention of cervical cancer is the Cervical Cancer Program. It is also managed by the National Health Service and targets HPV as one of the primary causes of the problem. One of its primary achievements was the implementation of the Gardasil vaccine, which “protects against four types of HPV, including two strains responsible for more than 70% of cervical cancers in the UK (HPV16 and HPV18)” (Sepabes & Feinstein 2006, p. 3008).

The final measure that is relevant to the topic is the Stop Smoking Service. This is another preventive policy that encourages adult women to engage in positive lifestyle behaviors and give up bad habits like smoking, which increases the risk of cancer.

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A very interesting aspect of the situation in the UK, is that while there are members of the adult female populace who do not screen themselves, the statistics for regular screenings are very high, and understanding the exact reasons might be very useful for building promotion campaigns for other types of screenings, However, the current state of the voluntary screening participation also reflects a tendency towards static, as the numbers have been mostly steady over the years, with the same percentages of non-participating women (Whynes, Philips & Avis 2007).

However, while a lot of the issues are being addressed, there are still a number of issues that are plaguing this area of health care. First of all, there are still chances of inaccuracy in the screening process, which may cause a woman to repeat the check, or even provide false results, causing a significant amount of mental distress. If the healthcare practitioners were unable to read the data from the sample, the patient may have to undergo it again. However, they will first have to experience a three-month hiatus (Cervical cancer screening n.d.)

Aim and Objectives

The primary aim of this research paper is to analyze the existing research, literature, and health policies in order to achieve a better understanding of the country’s cervical cancer primary prevention methods for adult women, their strengths and weaknesses, and contemplate how they can be improved. This paper also studies the secondary prevention methods, which address the situation of women already diagnosed with cervical cancer and how it is treated and mitigated.

The main objectives of the research study are summarized as:

  1. To assess cervical cancer prevention policies and measures in the UK.
  2. To analyze the measures aimed at managing and supporting adult women diagnosed with cervical cancer in the UK.
  3. To use the collected data to suggest improvements to the current cervical cancer policies and measures.
  4. Make projections for the future.

Literature Search

A literature search is a diligent and systematic search of all types of published literature for the purpose of building an array of high-quality references that are relevant to the purpose of the paper. Conduction a literature search will allow a better, more current understanding of the situation in the British healthcare industry in relation to prevention, mitigation, and treatment of cervical cancer in women above thirty. It would also help identify the past and current research findings into the topic, how they compare to this one, and what are the gaps in their findings and methods.

The studies of interest can be roughly divided into those which help create a better understanding of cervix cancer, particularly in Britain, the ones dealing with primary preventive care in Britain, and the research works and publications focusing on secondary preventive care.

The literature search would begin with background reading and preparation, in order to deepen the understanding of the subject. It is likely that during this state the seminal article or a book upon which content will be drawn will be discovered. Currently Carrieri and Bigger’s Preventive care: underused even when free. Is there something else that works?” fills this niche. Following this, the principle search terms and items will need to be identified, which will help broaden the scope of the search.

These will include relevant authors, concepts, names of policies, legislation, and organizations in conjunction with the key terms. The key terms of the paper are “cervical cancer”, “adult women”, and “Britain”, including the variations of the name. Others include “policy”, “measures”, “prevention”, “mitigation”, “treatment”, and “healthcare”.

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The literature will be searched primarily on Google, Google Scholar, and Google Books search engines, as well as available online libraries, and databases such as JSTOR and Academic Search Complete.

The paper will refrain from using literature concerning specifically younger females, focusing on tertiary disease prevention (rehabilitation), and more direct interventions (like surgery or chemotherapy). Finally, the research leaves out literature written before 2000 and will focus on the materials published in the last 5-10 years, unless an article has a recognized value and is referred to in the more recent publications (Faculty Librarians 2012).

Ethics and anti-oppressive practice considerations

Interacting with physicians, nurses, and, most importantly, patients, requires utmost ethical vigilance and respect for one’s privacy. It is important to understand that this paper has a distinct political purpose, which, ultimately, amounts to the improvement of the state of healthcare in the area of cervical cancer treatment in adult women over thirty, who lives in the UK. This puts a lot of responsibility on the researchers. It requires them to not only be respectful of the targets of their research but also to remain unbiased and conscious of works potential to instigate social change or the risks of secondary data being affected by political or social biases (Baines & Edwards 2015).

Project Outline

Chapter 1

This chapter will contain the introduction to the paper presenting the core concepts and establishing preventive cervical cancer care for adult women as the main question of the paper, will provide the background information for the problem in the UK, show how this paper is different from others. This chapter will also contain the literature collection strategy and ethical considerations.

  • Introduction
  • Background
  • Literature Search Strategy
  • Ethics and Anti-oppressive Practice Considerations

Chapter 2: Literature Review

In this chapter, the main topic-relevant literature gathered during the literature search will be listed, separated into three categories (related to the disease itself, primary prevention, and secondary prevention). Each piece of literature will be discussed in relation to how it contributes to the topic, with its strengths and weaknesses.

Chapter 3: Cervical Cancer Treatment Policy and Measures in the UK

The principal focus of this chapter would be the analysis of relevant policies legislation tackling cervical cancer, in particular, the aforementioned Cervical Screening Program, Cervical Cancer Program, and Stop Smoking Service, as well as other initiatives relative to patient care once cancer had already been diagnosed.

This part of the paper will discuss the results of such initiatives by comparing demographical data and statistics, and their effectiveness compared to each other. The paper would be greatly augmented with primary data, for example by interviewing physicians and nurses who are part of any one of those programs, and patients who either undergo preventive measures or were screened with cancer and are treated. In “Reflection on Policies and Measures”, the article will analyze the data from this chapter, and provide both criticisms and praise on the different aspects of UK cervix cancer policies and measures. Health education will be emphasized as the vital tool of cervical cancer prevention, with it being an effective way to increase the effectiveness of the existing policies and inspire women to screen themselves more often (Sabates & Feinstein 2006).

  • Cervical Screening Program
    • Strengths
    • Weaknesses.
  • Cervical Cancer Program
    • Strengths
    • Weaknesses.
  • Stop Smoking Service
    • Strengths
    • Weaknesses.
  • Secondary prevention measures
    • Strengths
    • Weaknesses.
  • Reflection on Policies and Measures

Chapter 4: Conclusions, recommendations, and reflection

The final chapter of the paper will focus on summarizing the results and main findings of the research. It would discuss the limitations of the study and the potential for future improvement upon it.

It would also provide a reflection on the results, what they mean for the healthcare industry, what strengths and weaknesses have been found within the policies and measures analyzed, and how the collected data can be used to augment the existing policies.

Project Timetable

From To Goals
December 10th, 2015 December 15th, 2015 Project preparation
December 15th, 2015 December 20th, 2015 Literature Research
December 20th, 2015 January 11th, 2016 Data and Research Collection
January 11th, 2016 Supervisor meeting
January 12th, 2016 January 15h, 2016 Feedback analysis.
January 15h, 2016 January 30th, 2016 Implementation of feedback.
January 30, 2016 February 15th, 2016 Draft paper write-up
February 15th, 2016 Supervisor meeting. Draft presentation
February 16th, 2016 March 16th, 2016 The second revision, implementation of feedback.
March 17th, 2016 May 2016 Research paper finalization
May 2016 Project Submission

Reference List

Baines, S & Edwards, J 2015, ‘Considering the ways in which anti-oppressive practice principles can inform health research’, Journal of Health Economics, vol. 42, pp. 28-34.

Bosch, FX, Lorincz, A, Munoz, N, Meijer, CJ & Shah, VK 2002, ‘The causal relation between human papillomavorus and cervical cancer’, Journal of Clinical Pathology, vol. 55, no. 4, pp. 244-265.

Carrieri, V & Bilger, M 2013, ‘Preventive care: underused even when free. Is there something else at work?’, Applied Economics, vol. 45, no. 14, pp. 239-253.

Cervical Cancer Incidence and Screening Coverage. n.d. Web.

Cervical Cancer Screening n.d. Web.

Faculty Librarians 2012, ‘Doing a literature search: a step by step guide’, Liverpool Hope University.

Landy, R, Canon, A, Dudding, N, Lim, AWW, Hollongworth, A, Hamilton, W & Sasieni, PD 2015, ‘Cervical cytology and the diagnosis of cervical cancer in older women’, Journal Medical Screening.

Moser, K, Patnick, K & Beral, V 2009, ‘Inequalities in reported use of breast and cervical screenings in Great Britain: Analysis of cross sectional survey data’, British Medical Journal, vol. 338, no.2, pp. 2015-2034.

Sabates, R, & Feinstein, L 2006, ‘The role of education in the uptake of preventative health care: the case of cervical screening in Britain’, Social Science Medical, vol. 62, no. 5, pp. 2998-3010.

Sprinthall, R 2011, Basic statistical analysis. Pearson Education, New York.

Whynes, D, Philips, Z & Avis, M 2007, ‘Why do women participate in the English cervical cancer screening programme?’. Journal of Health Economics, 26 (7), pp. 306-325.

Wu, S 2008, ‘Sickness and preventive medical behavior’, Journal of Health Economics, vol. 22, no. 11, pp. 675-689.

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