The Importance of Regular Cervical Screening
Health Screening // July 02, 2020
Every year 3,200 women receive a diagnosis of cervical cancer in the United Kingdom. Nearly all of those cases are preventable. Almost half of all women with cervical cancer haven’t been screened in the last five years or longer but the good news is that it takes between three to seven years for abnormal cervical cells to become cancer. With regular cervical screening, you and your gynaecologist can detect cervical cancer before it progresses.
Many fear their gynaecologist appointment because of the unknown, but cervical smears keep you safe. Taking charge of your health means caring for your reproductive organs. This article will review when, why and how to get cervical cancer screening.
What is Cervical Cancer?
The cervix is the lower part of the uterus that connects to the vagina. In childbirth, it is what dilates to allow the baby to pass through. Cervical cancer is the growth of abnormal cells in the cervix. If it progresses, the abnormal cells invade deeply into the cervix and can even spread to other parts of the body.
Cervical cancer is usually caused by human papillomavirus (HPV). While this virus causes genital warts, high-risk HPV is also to blame for the most dangerous forms of cervical cancer. HPV can cause cancer of the mouth, penis, anus, vagina, vulva and throat.
Why do I need to be screened for cervical cancer?
While HPV sounds terrifying, many sexually active people will get it in their lifetime. Unfortunately, it is asymptomatic. The scary part about it is that it enters cells and changes them. These abnormal cells are defined as low-grade or high-grade. When cells change like this, they can become cancerous.
When abnormal cells are not checked for a long time, they are more likely to become a high-grade change. Sadly, high-grade cervical cell changes are more likely to become cervical cancer. By following the guidelines for cervical cancer screening, you can catch any abnormal cells or high-risk HPV infection before it becomes cancer.
When do I need to be screened for cervical cancer?
Screening for cervical cancer begins at 25 years of age in the NHS. However, women between the age of 25 and 30 have the highest risk of cervical cancer so we recommend that screening should begin at 20 years of age.
Since 2019, screening in the NHS consists initially of an HPV test. If this is positive, the previously use smear test or cytology is performed to look for abnormal cells.
- If the HPV test is positive, but the smear test is negative, women are advised to have a further test in one year.
- If the HPV test is positive and the smear test shows abnormal cells, women are referred for colposcopy.
- The NHS recommends a cervical screening test every three years from age 25 to 49 and every 5 years from 50 to 65.
- You don’t have a history of severe abnormal cervical cells or cancer, and had three negative Pap test results or two negative co-tests in the past ten years.
- The most recent test should be performed within the past five years.
Many women in the private sector choose to have tests every year to make sure an abnormality is picked up earlier.
How does my gynaecologist screen for cervical cancer?
At 25 Harley Street, we place significance on keeping you well through preventative screening in many areas of your health. In this case, your gynaecologist screens for HPV and abnormal cells by taking a small sample from your cervix known as a Pap test or smear. The process is fast.
- Your provider inserts a speculum into your vagina while you lie on an exam table.
- The gynaecologist will open the speculum to provide a clear view of your vagina and cervix.
- Next, they will use a small brush to swab a sample of your cervix and place it in a fluid-filled container.
- Finally, they will remove the speculum and send the sample to the lab for testing by cervical cytology.
If your clinician is testing for HPV or co-testing, the test checks for the most high-risk HPV types that are more likely to cause cervical cancer. If you have a Pap test, the cervical sample will be evaluated to see if there are abnormal cells present.
What if the results are abnormal?
There is no reason to become alarmed if you have abnormal results. Your next steps will be based on your test results. For most conditions, you will need to repeat the pap test in one year. Even if you need further testing, a cervical biopsy or colposcopy is performed to check to see if the cells are high-grade changes. If there are high-grade changes, you will need the cells removed. Your Gynaecologist will follow up with you frequently to ensure that the abnormal cells resolve.
What about the HPV Vaccine?
The HPV vaccination prevents the infection of some but not all high-risk HPV types that may lead to cervical cancer. Ideally the vaccine is given at age 11 or 12 prior to sexual contact. However, it can be given to women of any age to reduce the risk of further HPV infection, although it doesn’t help to clear current infection. We think that women may be reinfected with the same HPV type or different types throughout their reproductive life so later vaccination makes sense for some older women.
If you have received the HPV vaccine, it does not change the routine screening recommendations. You should still follow the guidelines that pertain to your age group.
What circumstances change the testing guidelines?
If you have experienced any of the following, speak with your Gynaecologist regarding the best plan for cervical cancer screening. You may need to be screened more often if you:
- History of cervical cancer
- Exposure to diethylstilbestrol (DES)
- Human immunodeficiency virus (HIV)
A hysterectomy is the surgical removal of the uterus. Following a hysterectomy, you may still need screening. If you still have a cervix, you will follow the normal guidelines. If your hysterectomy was performed due to cervical cancer, you will need to continue screening for twenty years, even if you no longer have a cervix.
For further information, visit the following valuable resources:
- British Society for Colposcopy and Cervical Pathology ‘Frequently asked questions’ https://www.bsccp.org.uk/women/frequently-asked-questions
- NHS “When you’ll be invited for Cervical Screening” https://www.nhs.uk/conditions/cervical-screening/when-youll-be-invited/
- NHS Cervical Screening: programme overview. https://www.gov.uk/guidance/cervical-screening-programme-overview
- The Royal College of Obstetricians and Gynaecologists’ (RCOG) cervical smears in pregnancy https://www.rcog.org.uk/en/patients/patient-leaflets/cervical-smears-and-pregnancy/
If you’re looking for an unparalleled gynaecology service in London, we are your ideal team for reproductive health. Cervical cancer has a 51% survival rate, however, with proper gynaecological care, you can take the appropriate preventative care of yourself before it is too late. Your comfort is our primary concern. Make an appointment with a Phoenix Hospital Group Gynaecologist or call 0207 079 2102.