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Cervical Screening uptake: those aged 25-29 the rate of uptake is now just 66.2 per cent, after falling by 12.6 per cent in the past decade.
Oct 2008 estimate

Jade's history may have cost her life itself
One million women put health at risk by ignoring smear test invite
Joan Alison Smith
Joan Smith and the National Secular Society
Joan Smith bibliography
See also

Jade's history may have cost her life itself

Joan Smith 8 February 2009

The tragedy of Ms Goody reflects ill on us all

I've hardly ever seen Jade Goody on television. But I've been aware of her since she first appeared on Big Brother – and I've always felt uncomfortable about her. She has made a career as a "reality" TV star, earning more money than is usually available to someone from her working-class background, but at the price of confirming a huge number of prejudices. Her fame has been founded on negatives, from her lack of education to her dysfunctional relationships. Now she has been told her cervical cancer may be incurable, and an agonising set of circumstances is once again being lived out in the glare of publicity.

At one level, Ms Goody's reaction to the devastating news is understandable; she needs to go on working to secure the future of her two children, and living her life in public is the only job she has. Until her illness, she made good copy but got a bad press, becoming a single mother and graduating to Celebrity Big Brother, where she became embroiled in a row about alleged racism. The recent change in attitudes towards her says a great deal about class in this country.

For years, Ms Goody was treated as a semi-house-trained pet, willing to perform without fully comprehending the malicious pleasure she evoked. It wasn't just Big Brother fans who laughed at her ignorance of basic geography; gleeful commentators claimed her as a symbol of the worst aspects of working-class culture, as though people from her background are congenitally stupid. In fact, far from being stupid, Ms Goody made the most of an unexpected opportunity. She grew up in south London, with parents dependent on drugs, her father in and out of prison. It's hardly surprising that she did badly at school. She went on to have two children with someone from the only world she has ever known as an adult – another "reality" TV star. But she was never going to marry a Wykehamist and open a health food shop, was she?

Now we know that Prince Charles calls a black friend "Sooty" and the Queen thinks it's OK to sell golliwogs, the furore over Ms Goody's behaviour towards the Bollywood star Shilpa Shetty looks like double standards. While every possible excuse is trotted out for the racism of the upper classes, working-class people are torn to shreds.

I always thought Ms Goody's boorish attitude to Ms Shetty was more about class than race, a feeling which was confirmed when it emerged that Ms Goody herself is mixed race. She duly apologised and agreed to appear on the Indian version of Big Brother, which is where she received her original diagnosis of cervical cancer. The worst that can be said of Ms Goody is that she enjoys fame as much as Princess Diana, whose connection with the public was equally morbid.

In the princess's case, star quality and an aristocratic background transformed her hunger for attention into an improbable series of positives: empathy, informality, compassion. Ms Goody has had no such luck and she also failed to get treatment after an abnormal cervical smear, like too many working-class women.

The lack of education that made her a laughing stock seven years ago has shortened her life, and you would have to be very callous indeed not to see that as a tragedy.

One million women put health at risk by ignoring smear test invite
By Rebecca Smith,  28 Oct 2008

One million women in England are putting themselves at risk of cancer by ignoring invitations to have a smear test, latest data has revealed.
Although 4.18m women were invited to have the cervical smear test to detect pre-cancerous cells, only 3.22m were tested in 2007/8.

Overall the proportion of women who have been tested in the last five years has dropped in the last decade from 82.5 per cent in 1998 to 78.6 per cent last year, figures from the NHS Information Centre show.

The reason for the drop is not clear. It could be that women do not take the threat of cervical cancer seriously enough, or find that appointments with the nurse at their GP surgery are not convenient.

The biggest drop has been seen in younger women with uptake rates amongst those aged 25-29 at just 66.2 per cent after falling by 12.6 per cent in the past decade.

Julietta Patnick, Director of the NHS Cancer Screening Programmes said: “Over recent years we have seen a downward trend in women taking up their invitation to cervical screening, and the reasons for this are difficult to determine.

“We already know that younger women in particular are accessing screening less, and there are initiatives already underway to try and tackle this. Cervical screening saves around 4,500 lives a year, and it is important for women to consider this when deciding whether or not to accept their invitation.”

The NHS cervical cancer screening programme aims to test all women aged between 25 and 64 every three to five years and costs around £157m a year in England.

Uptake rates need to be 80 per cent or higher to provide the best protection against cervical cancer but rates are lower than that in 89 out of the 152 primary care trusts in England.

Schoolgirls aged 12 are currently being offered the human papillomavirus vaccine which protects against the strains of the sexually transmitted virus that cause most cases of cervical cancer.

In 2005 there were 2,803 women in the UK who were diagnosed with cervical cancer and 949 deaths the following year.

The data from the NHS Information Centre also revealed that new cervical smear testing techniques have reduced the number of women who need to be recalled for a repeat test due to an unclear reading.

Fewer than 100,000 women had to undergo a repeat test in 2007/8 compared to 300,000 before the liquid-based cytology test was introduced in 2003.

A spokesman for the Department of Health said: “We are aware that coverage rates are declining across the country, particularly in young women.

“To tackle this, NHS Cancer Screening Programmes (NHSCSP) have commissioned the Improvement Foundation to undertake a project to look into ways in which cervical screening uptake can be improved in women aged under 35.

“The project will cost £250,000, and the NHSCSP and Improvement Foundation have identified ten primary care trusts to work with. Lessons learned from this project will be shared across the whole programme by the end of 2009.”

A spokesman for the cervical cancer charity Jo’s Trust, said: “The latest figures are very concerning. They highlight the urgent need for a major awareness campaign to make women understand the importance of going for their smear test when invited. As the lead UK cervical cancer charity Jo’s Trust has a key role to play in trying to educate women and to understand the reasons for not going for a test that could ultimately save their life.”

Joan Alison Smith
Joan Smith columnist, critic and novelist(born 27 August 1953 in London) is an English novelist, journalist and human rights activist, who is a former chair of the Writers in Prison committee in the English section of International PEN.

Smith read Latin at the University of Reading in the early 1970s. After a spell as a journalist in local radio in Manchester, she joined the staff of the Sunday Times in 1979 and stayed at the newspaper until 1984, although Smith still contributes book reviews to the publication. She has had a regular column in the Guardian Weekend supplement, also freelancing for the newspaper and in recent years has contributed to The Independent, the Independent on Sunday, and the New Statesman.

In her non-fiction Smith displays a commitment to atheism, feminism and republicanism; she has travelled extensively and this is reflected in her articles. Smith has taken a strong anti-Iraq war stance. She is scornful of popular culture and once gave away her television set to a close friend, although she acquired a new set a decade later.

Outside the UK, Smith is probably best known for the Loretta Lawson series of crime novels. What Will Survive (2007) is a novel set in Lebanon in 1997 concerning a journalist's investigation into the death of a model and anti-landmine campaigner.

In 2003 she was offered the MBE for her services to PEN, but refused the award. Joan Smith is a supporter of Republic and an Honorary Associate of the National Secular Society.

Joan Smith was married to the journalist Francis Wheen between 1985 and 1993. She is currently romantically involved with Denis MacShane, a Labour Party politician in the United Kingdom.

National Secular Society
Honorary Associate: Joan Smith

Joan Smith is a columnist, critic and novelist. She has written columns for The Independent on Sunday and The Guardian and her reviews appear in the Financial Times, The Sunday Times and The Independent. She is one of the presenters on What the Papers Say and a regular contributor to BBC radio.

“Religion is only one strand in the way human beings construct their identity, and frequently a very divisive one. It actively encourages exclusivity, encouraging people to think in terms of their difference from the rest of humanity, rather than what we all have in common. It's because of that divisive tendency in religions that I think the most urgent task facing us is to ensure that that framework is based on secular values. What I advocate is a shift away from the kind of collective and coercive moral structure associated with religion, to one that combines modern individualism with a human rights framework.”

“I don't want Christian schools or Islamic schools any more than I want atheist schools or republican schools or feminist schools. I mean I happen to agree with all those three ideologies, and that's how I describe myself, but I don't want children indoctrinated in that, and I think the purpose of education is to give children choice.”

“It has also become apparent that, far from having a monopoly on goodness, Christians are no more likely than atheists to behave well to their fellow human beings. On the contrary, the Roman Catholic Church had a deplorable record of colluding with fascism throughout the 20th century, from the congratulations it bestowed on General Franco after the Spanish civil war, to its recent efforts on behalf of General Pinochet.”

“It is perfectly clear that you can be committed to equality and justice without being told to subscribe to them by a higher authority. The movement towards establishing universal human rights, in the form of international conventions and domestic law, is being driven as much by atheists and agnostics as believers. On the contrary, if you are not distracted by the prospect of an afterlife, it is all the more important to change the society we live in now and that we will hand on to future generations.”

“Clerics may disapprove of Prozac, but fairy stories are all they have to offer as an antidote to the human condition.”


Joan Smith (1985). Clouds of Deceit: Deadly Legacy of Britain's Bomb Tests. Faber.
Joan Smith (1989). Misogynies: Reflections on Myths and Malice. Faber. 
Joan Smith (1996). Hungry for You: From Cannibalism to Seduction - A Book of Food. Chatto & Windus. 
Joan Smith (1998). Different for Girls: How Culture Creates Women. Vintage.  
Joan Smith (2001). Moralities: How to End the Abuse of Money and Power in the 21st Century. Allen Lane. 

Loretta Lawson Novels
Joan Smith (1987). A Masculine Ending. Faber.
Joan Smith (1988). Why Aren't They Screaming?. Faber. 
Joan Smith (1990). Don't Leave ME This Way. Faber.
Joan Smith (1993). What Men Say. Chatto & Windus. 
Joan Smith (1995). Full Stop. Chatto and Windus. 

Joan Smith (2007). What Will Survive. Arcadia Books.

Joan Smith (1992). Femmes De Siècle. Chatto and Windus.

See also
Finding the g spot (by Joan Smith)
Sex and the City: They're older - but are we wiser? (by Joan Smith)
Why Karen Matthews really offended the middle classes
News on cervical cancer
Alcohol and middle class women
[145 KB PDF] Sociodemographic report on the uptake of cervical screening 2005

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