Cervical & HPV screening have reduced cancer deaths by 80% in recent decades. A well-attended screening programme prevents around 70% of cervical cancer deaths - a figure that could reach 83% if every eligible woman attended. England has committed to eliminating the disease by 2040, and the science says it's achievable. So why are 30% of minority women not up to date? And why do a further 1 in 5 say they’ve never attended a cervical screening appointment?

The barriers are real, varied, and worth understanding properly. That's why Daye launched In Their Language - a public health study on the barriers to cervical cancer screening today. 

A century of the same lesson

When George Papanicolaou began developing the smear test that bears his name, in the laboratories of early-twentieth-century New York, he had no patients of his own. So his wife, Mary, climbed onto his examination table nearly every day for twenty-one years and let him sample her cervix, some seven thousand times, until the test was ready for external patients. He presented it in 1928. The field shrugged. It took fifteen more years to be believed, and decades more to become what it is now: the reason cervical cancer deaths across much of the world have fallen by more than half.

The lesson behind that long delay is one medicine keeps relearning. Yes, the scientific discovery is long, expensive and challenging. But the science shouldn’t end with the breakthrough test - we need to ensure public health analysis is applied to how we actually reach and serve the patient too. 

The study

We surveyed over 1,000 ethnic minority women across the UK because this is the group that most often gets left behind in public health evaluations. We wanted the whole picture: who's attending, who isn't, and what's actually getting in the way.

What we found

Attendance isn't uniform - and treating it as if it is is the first mistake.

Black Caribbean women had the highest rate of always attending when invited (68.57%), followed by Black African (63.89%) and Mixed-race White and Black African women (60.58%). At the other end, Mixed-race women of any other background had the highest rate of non-attendance despite being invited (13.33%), followed by Asian Pakistani (12.68%) and Black Caribbean women (11.43%).

Treat "ethnic minority women" as a single bloc, and you design a solution for a person who doesn't exist. These figures aren't there to assign blame. They're there because you can't fix what you haven't measured.

Stigma is real, and unevenly distributed.

While 60% of ethnic minority women say intimate health is openly discussed in their communities, a significant number say it isn't - most commonly women from Pakistani (31%), Black Caribbean (29%), Bangladeshi (29%), and Black African (25%) backgrounds. A test you have never heard discussed is one you are unlikely to seek. Silence has consequences.

Faith and modesty are central to many women's experiences.

More than half (55%) say their religious beliefs affect how comfortable they feel with intimate health examinations in the clinic. Nearly two-thirds (65%) say modesty matters to their faith. For many communities, the appointment isn't a neutral clinical event - it's a decision shaped by deeply held beliefs. These aren't edge cases. They're the everyday experience for many of the women we spoke to.

Practical barriers compound everything else.

Access challenges vary by region: around a third of women in Wales, Scotland, and the South East cite difficulty booking, limited female clinicians, or long waits. In Northern Ireland and the North West, nearly a third say childcare makes attendance genuinely hard. In multiple regions, language barriers mean the invitation arrives, but the information doesn't. None of these are insurmountable in isolation. Together, they add up.

Women know what would help.

A clinician who understands their background. A clear explanation of what will happen. A female practitioner as the default rather than a special request. A third said they'd feel more comfortable attending if the procedure had been explained beforehand. They weren't asking to be persuaded - they were asking to be informed and trusted to decide for themselves.

The good news

The trajectory is genuinely hopeful, and women deserve to hear that.

HPV causes 99.8% of cervical cancers, which means a cancer with a single dominant cause is a cancer we can engineer out of existence. The vaccine is doing exactly that. Women offered it at age 12–13 have 87% lower cervical cancer rates than unvaccinated generations. We are watching a cancer start to disappear in real time.

Where Daye fits Pic for this

Daye's at-home HPV Screen is designed for the gaps between NHS appointments - which are now five years apart for many women. It returns results in days, and the same tampon-based sample can also screen for common STIs and vaginal infections. For women who find a clinic setting difficult, it offers a private, familiar alternative.

It works alongside NHS screening - never instead of it. If you test positive for HPV, we help you book your pap smear and your HPV catch-up vaccination. 

Why we think this works - and where we've tested it

Daye's approach isn't theoretical, and it isn't only British. Our global health HPV screening programmes run in Nigeria (the CATCH study) and Tanzania (TASAAHILI, in partnership with UCL and MUHAS), in exactly the kinds of communities where modesty, faith, and access shape whether a woman screens at all. That matters here because the barriers ethnic minority women in the UK described to us - a preference for privacy, discomfort with clinical examination, faith-informed reservations about intimate procedures - are the same barriers a tampon-based, self-collected format is designed to remove.

And the format holds up in precisely the populations most often left out. In our research, Muslim women who hadn’t used tampons before found the at-home tampon an acceptable way to screen - a meaningful signal when more than half of the women we surveyed say faith affects their comfort with intimate examinations, and nearly two-thirds say modesty matters to their faith. A test you can take yourself, at home, without a speculum or a stranger, isn't a workaround for these women. For many, it's the difference between screening and not.

Free resources, in nine languages - and a product built to be understood

We've made downloadable guides on what to expect from your smear test in Gujarati, Hindi, Arabic, Bengali, Urdu, Punjabi, Swahili, Somali, and Polish. And because information shouldn't stop at the invitation, our at-home HPV Screen ships with instructions for use translated into twelve languages — so the test doesn't just arrive, it makes sense.

Please share them.

What to expect at your NHS smear test

A third of women told us they'd feel more comfortable attending if the procedure had been explained beforehand. So here it is.

Step 1: You'll receive an invitation by text, post, or the NHS app. When you book, you can ask for a female clinician, an interpreter, a chaperone, or extra time.

Step 2: The clinician should explain the procedure before anything happens. The appointment takes around 10–15 minutes. If you're worried about discomfort, ask for a smaller speculum, more lubricant, a slower pace, or pain relief.

Step 3: You undress from the waist down behind a privacy curtain, with a cover provided. The clinician leaves the room and comes back when you're ready.

Step 4: The test itself takes less than a minute. A speculum is inserted, a brush collects a small cell sample from the cervix. It can be uncomfortable. Once it's done, you have privacy to get dressed in your own time.

Step 5: Results arrive by text, letter, or the NHS app. They can take several weeks. You'll be contacted if any follow-up is needed.

Moving forward

Cervical cancer is becoming a disease we can choose to leave behind - but only if screening reaches the women who need it most.

Mary Papanicolaou gave twenty-one years of her own body so that women she would never meet might be spared this cancer. The least we owe her, and them, is to find out why so many of those women still don't come - and then to believe what they tell us.

Over a thousand of them just did.