Millions of women are putting themselves at risk of cervical cancer by missing smear tests, figures suggest.
Around three million women across England have not had a smear test for at least three-and-a-half years, according to data from Public Health England.
Cervical cancer screening rates are therefore the lowest they have been for two decades.
Smear tests help to prevent cervical cancer by checking the health of the entrance of the womb and detecting any abnormal cells.
They are thought to prevent 2,000 cervical cancer deaths a year in the UK.
Millions of women are putting themselves at risk of cervical cancer by missing smears (stock)
The number of women having smears initially increased after the Big Brother star Jade Goody died from the disease at just 27 in 2009, however, uptake has since fallen.
Women aged between 25 and 49 who are registered with a GP are invited for a cervical screening every three years.
But in some areas of the country, half of women under 50 do not have a smear test in this time frame, PHE data suggest.
Overall in England, just 72 per cent of women under 50 have a smear test within the recommended three years, according to March 2017 figures.
This is down for 75.4 per cent in 2012.
And a million women aged 50 to 64 have not had a smear test for at least five-and-a-half years. Women of this age are invited to be screened every five years.
London has some of the lowest screening rates, with just over half of 25-to-49 year olds having a smear in the past three-and-a-half years in certain boroughs, PHE data shows.
In the boroughs of Westminster, Kensington and Chelsea, Camden and Hammersmith, and Fulham, only around half of women aged 25 to 49 have a screening in the recommended time frame.
While Cambridge and Oxford have screening rates of 54 and 55 per cent, respectively.
In Leicester, 60 per cent of women under 50 have smear tests as recommended, compared to 61 per cent in Luton, and 62 per cent in Manchester, Slough, Haringey and Birmingham.
Rushcliffe in Nottingham is among the best, with 80 per cent of women being screened as they should.
Jade Goody died from cervical cancer at just 27 in 2009. She is pictured on Celebrity Big Brother in 2007 with Bollywood actress and the show’s winner Shilpa Shetty, who she was accused of racist bullying. Goody’s death saw smear tests rates initially rise but then fall
‘Cervical screening is not a mandated requirement for local authority commissioning,’ Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare, explained to the BBC.
‘Local authorities under severe budgetary pressure are not including this essential aspect of women’s healthcare in their service specifications.
‘Screening rates are now at their lowest in two decades and the minimum 80 per cent national target is far from being achieved.’
A survey of more than 2,000 women by the charity Jo’s Cervical Cancer Trust suggested that many are simply too embarrassed to attend smear tests.
Of those who decline screening, 35 per cent are self conscious of their figures, 34 per cent are embarrassed by their vulvas’ appearance and 38 per cent worry their genitals smell.
And a third would not have a smear if they have not waxed or shaved their bikini line beforehand.
Fifteen per cent even admitted they would miss a screening for a gym class or a waxing appointment.
Research by University College London suggested women from minority ethnicity groups are less likely to be aware cervical screening is even available.
GPs in north west London also face language barriers and religious concerns, according to a spokesperson from the area’s clinical commissioning group.
Women in this part of the capital are therefore being offered evening and weekend screening appointments to make them more convenient.
Robert Music from Jo’s Cancer Trust said there is ‘no one magic solution’ to improve smear uptake, but the charity is working with GPs to provide drop in surgeries, phone clinics and ‘engagement with community or faith groups’.