Cervical screening for women with learning disability: current practice and attitudes within primary care in Edinburgh

Abstract

Accessible summaryIt is important that all women have a regular smear test. A smear test is a check up to make sure your cervix is healthy. Your cervix is inside your vagina. A smear test helps to find changes in your cervix that might become cancer if they are not treated. Your smear test is usually done by the doctor or nurse at your doctor's surgery.Women with learning disability do not go for their smear tests as often as other women. We asked doctors and nurses how they give smear tests to women with learning disability. We also asked them what they think about this.We found that: Often they do not know which of their patients have learning disability. They do invite women with learning disability to have their smear tests. Women with learning disability may not come for their smear tests for different reasons. Doctors and nurses need help to encourage women with learning disability to come for their smear tests. SummaryThis study aimed to evaluate current practice in, and to explore primary care professionals’ views about, providing cervical screening to women with learning disability, in two areas of Edinburgh. A postal questionnaire was sent to all 24 GP practices in the project area: 20 responded. Seven respondents were invited to participate in follow up interviews: six agreed. Results show that many practices lack robust mechanisms to identify their patients with learning disability; the low uptake of cervical screening by women with learning disability is not primarily because they are excluded from invitation for screening; practices vary in how they adapt the process of cervical screening to meet the needs of women with learning disability; and professionals make pragmatic decisions when considering screening for women unable to give informed consent. Primary care professionals need guidance and support to offer and provide screening appropriately to women with learning disability.