CervicalCheck initiatives improve access to screening

The HSE’s CervicalCheck programme celebrated Cervical Cancer Prevention Week by highlighting how screening is now even more accessible to all eligible women. More than 4,000 healthcare professionals across the country provide CervicalCheck screening across a range of community and healthcare settings, including general practice, some of Ireland’s sexual assault treatment units (SATUs), and Limerick Female Prison.

Connie McGilloway, Advanced Nurse Practitioner and Forensic Clinical Examiner at the Donegal SATU, developed a trauma-informed cervical screening follow-up clinic in the SATU after noticing many women attending the unit had never been screened or were not up-to-date with their appointments.

Ms McGilloway said: “Since 2017, our SATU’s follow-up clinic has been providing cervical screening to women in a trauma-informed, non-judgmental environment where they feel safe. Our work is supported by CervicalCheck and Letterkenny University Hospital gynaecological service.

“When we discuss screening, some women talk about feeling embarrassment, shame, and guilt related to their experiences; or they are fearful they will have to talk about the abuse with their GP or practice nurse. But by far the most common reason for not having a screening test was related to the nature of the test itself. For a woman who has suffered some form of unwanted sexual contact, the trauma of that intimate examination can be overwhelming.

“We consider everything from how we touch the woman to the words we use, and offer flexible appointment times after college or work. We give more time for the test, going at the woman’s pace, gaining her consent for every step to share control of what happens and when.

“The need for the service is reflected in the fact that we have a higher-than-average number of women who have a subsequent referral for follow-up in colposcopy. The reason for that could be lack of early detection, the fact they haven’t had a test before. Women tell us afterwards if they knew they would be looked after that way during the test they would have had one earlier.”

Chief Nurse Officer in Limerick Female Prison, Edel Muldowney, spearheaded an initiative to offer cervical screening onsite in the prison. She said: “Up until 2023 the medical wing was shared with the male population so it was more difficult to offer women gender-based healthcare.

“Our medical team didn’t include a trained CervicalCheck sample taker, so if women wanted cervical screening, they were escorted to a GP practice by two or three guards. Understandably, a lot of women declined.

“The new building was designed to support trauma-informed healthcare and its opening coincided with the appointment of a female GP. We were also supported by a consultant gynaecologist, who offered expertise on what we needed to set up cervical screening inside the prison.

“Our nurses were trained by the team from CervicalCheck’s Screening Training Unit. Initially, I ran a screening clinic twice a month. Now our GP runs a Well Woman clinic one day a week alongside the GP service, offering screening, contraception, and menopause advice.”

Prof Nóirín Russell, CervicalCheck Clinical Director, HSE National Screening Service, added: “Thanks to Edel and Connie’s expertise and commitment, more women are benefiting from trauma-informed healthcare. We want to support all women to have the benefits cervical screening offers by identifying and reducing the factors that stop them attending.

“We are particularly interested in initiatives that reach out to marginalised women as we know that nearly half of all cervical cancers are diagnosed in women who never attend for screening. Reaching these women and helping reduce barriers will help drive us towards Ireland’s goal of eliminating cancer in every community by 2040.”

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