Wellness
Millennial women are missing lifesaving cancer checks – how to close the cervical screening gap
As new European research shows millennials are more likely to miss cervical cancer screenings than any other generation, experts warn that failing to address major barriers – from fear to family and workplace pressures – could undermine global elimination targets.
Results from a survey of over 5,500 women aged 16-64 found that 31 per cent of eligible millennials have postponed or missed their cervical screening appointments, a figure that is 27 per cent higher than the average across all age groups.
The research, commissioned by Roche Diagnostics and conducted by GWI across six European countries, also found that, despite screening services being widely available free of charge or heavily subsidised in many countries, specific challenges make accessing routine cervical screening difficult for some.
Fears related to pain, embarrassment or stigma surrounding cervical screenings are well-documented as contributing to lower screening rates. But the research also reveals particular challenges millennials face in balancing careers, caregiving responsibilities, and relationships often result in appointments being missed or delayed at a higher rate compared to other age groups.
The ‘have it all’ generation?
“Millennials are often said to be the ‘have it all generation,’ juggling careers, caregiving, and societal expectations. Yet, they tend to put themselves last,” said Joanna Sickler, Vice-President, Health Policy and External Affairs at Roche Diagnostics.
“The research shows that millennials are disproportionately failing to prioritise cervical screening because of a mix of emotional, logistical, and societal pressures.”
Cervical cancer affects more than 600,000 women globally every year, yet it is preventable in almost all cases through vaccination, early detection, and treatment of precancers. Cervical screenings remain vital for detecting human papillomavirus (HPV), the cause of over 99 per cent of cervical cancers, but participation has declined in recent years.
In England, cervical screening rates have fallen to around 69 per cent for women aged 25–64 – well below the NHS England target of 80 per cent – with rates lower for younger women (66 per cent) than older women (74 per cent). According to NHS data, this means over five million women are not up to date with their routine check-up.
The high prevalence of millennials missing screening appointments is particularly concerning, given that they may be the age group that is most at risk. Between 1990 and 2019, cases of early-onset cancer among people under 50 increased by 79 per cent worldwide, and mortality by 28 per cent, making millennials the first generation at greater risk of developing tumours than their parents.
Research also indicates a rise in cases of cervical cancer among millennial women, despite the World Health Organization’s commitment to eliminating it as a public health problem by 2030. A study published in JAMA in 2022 revealed that the incidence of the disease has risen by an average of 2.5 per cent per year among women 30 to 34 years old since 2012.
Experts believe that the reduction in screening uptake among this age group could be contributing to the rise in cervical cancer rates.
A separate study, published in JAMA Network Open, found that of over 20,000 US women surveyed between 2005 and 2019, the percentage of those overdue for cervical cancer screening rose from 14 per cent in 2005 to 23 per cent in 2019.
Women aged 21–29 were significantly more likely to be overdue for screening than those between the ages of 30 and 65.
Fear remains the biggest barrier
According to Roche’s research, fear remains the biggest barrier to attending cervical screenings, with 30 per cent citing fear as the primary reason for missing or delaying their appointments, driven by anxiety about discomfort, pain, or the potential results. This was particularly common among younger generations.
In Spain, 43 per cent of respondents cited fear as a reason for delay, the highest across all surveyed markets. Across the wider survey, 36 per cent of those aged between 16 and 34 years old and 37 per cent of those without children were also significantly more likely to delay due to fear.
This appears to be compounded by a lack of awareness and open dialogue about cervical screening. Despite various public health initiatives to encourage uptake, nearly 50 per cent of respondents, including 43 per cent of millennials, admitted they had never spoken to anyone about cervical screening, with 10 per cent saying they would be more likely to attend if encouraged by family, friends, or colleagues.
“It’s important to create an environment where discussing cervical screening and women’s health topics is not only accepted but encouraged,” Sickler tells Femtech World.
“This can only happen if these topics become commonplace in homes, workplaces and communities.”
Work, family and societal pressures
But fear is not the only factor.
The survey also found that professional commitments and workplace demands are the second-largest barrier for all participants. High-income earners, or those in the top third of income ranges across markets, are 22 per cent more likely than average to delay appointments, and 27 per cent of this group cite workplace demands as the reason for postponement.
Caregiving responsibilities are also often prioritised over personal health, particularly for parents, with 27 per cent of parents surveyed reporting they had delayed or cancelled cervical screening appointments.
Among millennials who postponed their screenings, 12 per cent identified assistance with travel or childcare as a significant motivator, while 19 per cent said greater workplace flexibility and encouragement from employers would help them prioritise their appointments.
According to Sickler, although 66 per cent of managers agree on the importance of taking an active role in supporting employees to attend screenings, only 14 per cent offer flexibility, and just eight per cent have discussed the topic at work.
At the same time, evidence shows the burden of cervical cancer falls disproportionately on marginalised and underserved communities, with incidence rates of cervical cancer in the UK 65 per cent higher in the most deprived quintile of the population, and approximately 520 cervical cancer cases each year linked to deprivation.
Meeting women where they are
Professor Daniel Kelly OBE, Cardiff University, and co-chair of the HPV and Hep B Action Network at the European Cancer Organisation, says healthcare systems “must evolve to meet women where and how they live”. And more broadly, society and communities should “foster open dialogue” to “normalise cervical health as a shared responsibility”.
Sickler agrees that healthcare systems must adapt to better address some of the barriers facing millennial women through practical and cultural solutions – from strengthening awareness and support to streamlining booking systems and expanding access to alternative screening options like self-sampling.
“The latest findings highlight opportunities to improve screening participation through education, workplace flexibility and access to resources,” she says.
“Whilst millennials are the most likely to miss cervical screening appointments, our research also shows they are also the generation most likely to request alternative screening options (21 per cent) and a more convenient booking process (35 per cent).
“To meet these needs, health systems could expand alternative screening options such as self-collection, which offers privacy and convenience and helps overcome barriers like embarrassment, fear of discomfort, and cultural stigma.
Sickler adds: “Streamlining booking processes, strengthening patient education, and fostering open conversations to normalise cervical health are crucial steps in overcoming key barriers.”
NHS to roll out home HPV testing
In England, where the NHS has promised to eliminate cervical cancer by 2040, more women are expected to be offered home screening kits as part of the cervical screening programme outlined in the recently published 10 Year Plan.
From January 2026, HPV self-sampling kits will be offered to those who have rarely or never attended their cervical screening appointment to allow them to test at home. The programme is specifically aimed at groups consistently missing vital appointments, including younger women, ethnicities facing cultural hurdles, people with disabilities and the LGBT+ community.
The new policy was informed by research carried out by King’s College London in 2021, which provided HPV self-sampling kits to women and people with a cervix who were at least six months overdue for their cervical screening. The YouScreen trial found that offering self-sampling kits could boost the numbers screened in England by about 400,000 each year.
According to Dr Anita Lim, visiting senior research fellow at King’s and chief investigator of the trial, the findings demonstrated that self-sampling could reach people who find it difficult to attend traditional screening, including those from diverse and underserved populations.
“It’s hugely positive to see this now reflected in national policy, helping more people get protected from this highly preventable cancer,” said Lim.
While screening carried out by a clinician is still considered the “gold standard” for HPV testing, experts and leading charities such as Cancer Research UK and The Eve Appeal have welcomed the initiative, saying it will help remove barriers and make cervical screening more accessible. And anyone who tests positive for HPV through self-sampling will be encouraged to attend a clinician-taken follow-up screening test.
“The gold standard way to test for HPV is still a sample taken by a clinician, and this will be suitable for most people,” said Michelle Mitchell, Chief Executive of Cancer Research UK, when the plans were announced back in June.
“But beating cervical cancer means beating it for everyone, and this move helps to bring us closer to that goal.”
A ‘societal movement’ to beat cervical cancer
Improving access to self-screening is one solution, but as Sickler highlights, it’s not the whole solution.
Roche’s new campaign, ‘Cervical cancer: it only ends with all of us’, focuses on several different ways to encourage those eligible to overcome barriers and attend clinician-collected cervical screenings.
This includes promoting more emotional and practical support from loved ones, better education across communities, and open conversations around the topic.
“The campaign aims to improve attendance rates through a societal movement to encourage and empower eligible populations to attend their cervical screening appointments,” Sickler adds.
“Only by creating an inclusive environment where women’s health topics are discussed will we be able to increase attendance and prevent cervical cancer from continuing to claim lives.”
Light exercise and less sitting may reduce pregnant women’s risk of serious blood pressure complications, according to a new study.
Researchers have proposed a daily activity and sleep guide that they say was linked to a nearly 30 per cent lower risk of hypertensive disorders of pregnancy.
The suggested pattern includes fewer than eight hours of sedentary time, at least seven hours of light physical activity, around 22 minutes of more intense activity and nearly nine hours of sleep.
The University of Iowa-led study examined the daily behaviours of 470 pregnant women across all stages of pregnancy.
Participants wore monitors that measured physical activity over 24-hour periods and recorded how long they spent asleep.
Hypertensive disorders of pregnancy include chronic high blood pressure, gestational hypertension and pre-eclampsia.
Gestational hypertension is high blood pressure that develops during pregnancy, while pre-eclampsia is a potentially serious condition involving high blood pressure and signs that organs may be affected.
Sedentary behaviour means being mostly inactive, such as sitting or lying down.
Light physical activity can include casual walking, moving around the home or standing.
Moderate to vigorous activity includes movement such as brisk walking, where breathing and heart rate increase.
Kara Whitaker, associate professor in the department of health, sport, and human physiology at Iowa and corresponding author of the study, said: “We are identifying the optimal composition of movement behaviours across the day associated with the lowest risk of developing HDP and the most improved health outcomes.
“This blueprint holds for each and every trimester of pregnancy.”
Study participants were enrolled at sites in Iowa City, Pittsburgh and Morgantown, West Virginia.
The women wore activity and sleep monitors for at least one week during each trimester of pregnancy.
Four in five participants were non-Hispanic white and nearly a quarter lived in rural areas.
The data showed a steep rise in risk among pregnant women who were sedentary for more than 10 hours a day.
Women who increased light physical activity to at least four hours a day reduced their risk of hypertensive disorders of pregnancy to 15 per cent from 30 per cent.
Whitaker said: “Just moving around more seems to have significant health benefits.
“And I think it also may be a more feasible target for women who are pregnant who are not exercising regularly.”
The researchers said they were surprised that longer durations of moderate to vigorous physical activity did not appear to provide additional benefit.
Sleep beyond a certain duration also did not appear to bring major further benefits.
Whitaker said: “Through this study, we are providing evidence that reducing sedentary behaviour and engaging in light physical activity are important, and maybe more important, when it comes to pregnancy and health.”
The findings may be relevant beyond pregnancy because clinical research has shown that women who develop hypertensive disorders of pregnancy are more than twice as likely to develop heart disease later in life.
Cardiovascular disease includes conditions affecting the heart and blood vessels, such as heart disease and stroke.
Whitaker said: “We know that cardiovascular disease is the number one killer of women, and if we can intervene in pregnancy and prevent women from developing a hypertensive disorder of pregnancy, we are putting them on a better trajectory, away from cardiovascular disease and toward more optimal cardiovascular health.”
The study was published online on June 10.
A second study, published online on May 27, looked more closely at the ratio and type of sedentary behaviour and light physical activity linked to a lower risk of hypertensive disorders of pregnancy.
Whitaker is a lead co-author on that study.
Co-authors in the June 10 study include Alex Crisp, Jaemyung Kim, Karina Smith, Donna Santillan, Mark Santillan and Bridget Zimmerman, from Iowa; Jacob Gallagher, from Iowa State University; Melissa Jones, from Oakland University in Michigan; Bethany Barone Gibbs, Katrina Wilhite, Alexis Thrower and Iqra Sheikh, from West Virginia University; and Sabera Rahman, Janet Catov, Christopher Kline and Maisa Feghali, from the University of Pittsburgh.
The National Institutes of Health, the University of Iowa Institute for Clinical and Translational Science, the University of Pittsburgh Clinical and Translational Science Institute and the West Virginia Clinical and Translational Science Institute funded the research.
Pregnant women’s expectations about postpartum sleep may predict sleep quality after birth, outweighing prior sleep and psychiatric history, a study suggests.
The findings suggest attitudes and beliefs about sleep during pregnancy could be a modifiable risk factor for postpartum sleep concerns.
They also indicate that, among women expecting the poorest sleep, higher postpartum anxiety may further worsen sleep quality.
Sammy Dhaliwal, lead author is clinical health psychologist and research fellow in the department of obstetrics and gynaecology at the Perelman School of Medicine at the University of Pennsylvania.
Dhaliwal said: “Most pregnant women in our sample anticipated poor postpartum sleep before it occurred, and it was striking that those expectations predicted worse sleep outcomes even after accounting for factors such as prior sleep disorders, psychiatric history, and number of previous births.
“This suggests that attitudes and beliefs about sleep during pregnancy may represent a modifiable target for early intervention before postpartum sleep problems emerge.”
Sleep disturbance affects an estimated 60 to 80 per cent of postpartum women and is linked to a higher risk of depression and anxiety.
Researchers said it is often regarded as an expected part of life after childbirth rather than a health issue that may be addressed earlier.
The study enrolled 432 pregnant women at about 24 weeks of gestation, meaning around 24 weeks into pregnancy.
Participants completed measures of their expectations about postpartum sleep, current sleep quality using the Pittsburgh Sleep Quality Index, and mood using validated depression and anxiety scales.
Assessments were repeated at six, 12 and 24 weeks postpartum.
A subset of 49 women also wore wrist actigraphy devices at six to eight weeks postpartum.
Actigraphy uses a wearable device, similar to a watch, to estimate sleep and wake patterns based on movement.
The results showed that 70 per cent of pregnant women, or 301 of 432 participants, expected poor sleep in the postpartum period.
Researchers found that predicted sleep disruption during pregnancy was a significant predictor of postpartum sleep concerns.
Among first-time pregnant women without prior health concerns, those who expected greater sleep disturbance had significantly more disrupted sleep after birth, measured by both actigraphy and self-report.
Among women who expected the worst sleep quality, higher postpartum anxiety significantly worsened both measured sleep and self-reported sleep, independent of anxiety levels during pregnancy.
Dhaliwal said the findings point to two possible areas for intervention: addressing sleep-related beliefs during pregnancy and treating postpartum anxiety.
Dhaliwal said: “Postpartum sleep disruption is often treated only after problems develop, but our findings suggest there may be an opportunity to intervene earlier during pregnancy.
“Addressing sleep-related beliefs and postpartum anxiety during prenatal and postpartum care may help improve sleep and emotional well-being in new mothers.”
A four-week Pilates programme may improve heart, metabolic and stress measures in previously sedentary women, a small study suggests.
Pilates is a mind-body form of exercise that has been linked to better fitness, balance, posture, muscular endurance, mental wellbeing and quality of life in different groups.
Built around breathing, concentration, control, precision, centring and flow, Pilates is already used in physiotherapy, rehabilitation and preventive health. The new study looked at whether a structured four-week programme could affect cardiovascular, metabolic, body and stress-related measures in sedentary adult women.
The longitudinal study included 30 sedentary women split into two age groups, 30 to 40 and 50 to 60.
All participants completed a standardised, supervised Pilates programme lasting four weeks, with three sessions a week lasting 50 to 60 minutes.
Researchers measured resting heart rate, systolic and diastolic blood pressure, body mass index, abdominal circumference, fasting blood glucose and serum cortisol at the start and end of the programme.
Systolic and diastolic blood pressure are the top and bottom readings in a blood pressure test. Cortisol is a hormone linked to the body’s stress response.
The four-week Pilates programme was linked to improvements in cardiovascular, metabolic, body and neuroendocrine measures, although not every change reached statistical significance within each age group.
In the younger group, significant reductions were seen in heart rate, blood pressure, body mass index and fasting blood glucose after the intervention.
The reduction in blood pressure after the programme was significantly greater in the older group than in the younger group.
Older participants also showed a greater reduction in glucose and cortisol levels after the intervention than younger participants.
Analysis also found significant links between cardiovascular, metabolic and neuroendocrine changes.
In the younger group, this was particularly seen between heart rate and blood pressure responses.
In the older group, it was particularly seen between changes in body mass index and fasting glucose.
The findings suggest Pilates could be a useful multidimensional exercise approach for cardiometabolic health and stress regulation in previously sedentary women.
The researchers said the larger reduction in blood pressure seen in the older group may reflect a higher cardiometabolic burden at the start, leaving more room for improvement after the programme.
The greater reduction in fasting glucose and cortisol in older participants may similarly suggest that people with higher baseline metabolic and neuroendocrine dysfunction could benefit more from structured exercise such as Pilates.
Although Pilates is known to improve body composition through energy use, neuromuscular activation and support for healthier habits, the researchers said the fall in body mass index over four weeks is unlikely to be explained by Pilates alone.
They noted that participants were also told to avoid alcohol, sugar-containing products and sugar-sweetened drinks during the intervention, which may have contributed to the change.
In the younger group, the link between heart rate and blood pressure suggested coordinated cardiovascular responses after Pilates.
The researchers also found that cortisol appeared to be linked to blood pressure and body mass index, suggesting stress-related changes may be tied to cardiovascular and body regulation after the intervention.
In the older group, the link between body mass index and fasting glucose highlighted the relationship between body fat and metabolic regulation.
A positive link between blood pressure and body mass index in this group also suggested that improvements in vascular regulation may be associated with reductions in body mass.
Overall, the findings suggest Pilates-related physiological changes may involve interconnected cardiovascular, body, metabolic and neuroendocrine mechanisms, with different response patterns by age.
The study has important limits. It did not include a non-exercise control group, so it cannot prove Pilates directly caused the changes.
The sample size was also small, which limits how far the findings can be applied more widely.
The authors also noted that cortisol was measured using a single fasting morning sample, which limits conclusions about broader hypothalamic-pituitary-adrenal axis regulation, the system involved in the body’s stress response.
They said larger studies with longer follow-up will be needed to confirm whether Pilates causes these physiological changes over time.
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