Sorry, but cervical screening is very much a women’s issue

Cancer Research UK has caused uproar with a tweet reminding us all that cervical screening, commonly known as the smear test, is important for “anyone aged 24-65 with a cervix”. Yes, anyone. In an attempt not to leave transgender men out of its advertising campaign, the charity has provoked fury by not referring specifically to women: outrage from feminists that they are being “erased”, and anger from transgender people justifying the language.

What a mess around something that was trying to raise awareness of a very real problem. Uptake of cervical smear tests in Britain is at a 20-year low – one in four people invited to attend one don’t. Every year more than 3,200 women are diagnosed with cervical cancer, and 890 die of it. It’s true that many transgender men still have a cervix, and deserve proper care and screening. The problem is that public knowledge about this topic is already very muddled.

For a start, cervical screening doesn’t detect cancer; it’s designed to spot the changes that might lead to it, so women can be monitored and treated if necessary. But abnormal results don’t mean you will get cancer, especially for younger women who get them more often – part of the reason why, in 2003, the Department of Health raised the screening age from 20 to 25. In a 2014 Lancet study comparing England with Wales (where screening starts at 20), researchers estimated that, for every 100,000 women given screening from age 20, eight or nine cancers would be prevented – but that it would also lead to 3,000 more women receiving unnecessary treatment.

Similarly, since cervical screening is unnecessary unless you’re sexually active (as you won’t have been exposed to genital HPV, which is what causes cervical cancer), there are many women who don’t need to be screened at 25 at all.

Why is that relevant to gender inclusion? Because, as numerous nurses pointed out to Cancer Research on Twitter, many women don’t even know what a cervix is, let alone whether they have one. So taking the word “women” out of the equation layers yet more confusion onto an already confusing subject.

Doctors and health experts need to inform and be clear in their language. After all, what they are aiming for is outcomes: for more women, or “people with a cervix”, to respond to the invitation to cervical screening.

The reality is that cervical cancer is relatively easy to tackle if it is spotted, which is simply done by carrying out a smear test. And although compulsory HPV vaccination will have almost eliminated it in young women by 2040, in the older generation, diagnoses are set to rise. Is politically correct language – no matter how wellintentioned – going to improve those rates? I doubt it. Reach out to transgender men, by all means. But don’t remove “women” from the equation. Lives depend on it – whether you identify as a woman or not.