Cervical cancer screening: what is a Cervical smear test?
It seems incredible but even today there is still a lot of ignorance around this topic. In the UK alone we lose approximately 2 lives a day because of this.
There are a lot of questions about this test:
Does the smear test hurt?
How often should I have my smear test?
What to do before my smear test?
What does the cervical smear test results show?
And so on.
In this article, we will respond to all these questions and we are sure that after reading this we will see you or you will see your GP . So if you are due for a test and haven’t done so already – book your smear test appointment today.
Cervical screening in the UK: why is it a life-saving test?
5 million women are invited for cervical screening every year in the UK and the statistics are telling us 1 in 4 women do not regularly respond. This is a sad data to read since every year over 3,000 women are diagnosed with cervical cancer and sadly 1,000 will lose their lives to the disease.
Regularly attending your cervical smear test, will help you take proactive action against this disease. Although your cervical screening does not represent a treatment it allows us to detect early ( and very treatable ) disease without letting it develop into cervical cancer.
Knowing that cervical cancers can be prevented by cervical screening, should help us understand the power of this simple but life-saving test. If everyone attended screening regularly, 83% of cancers could be prevented.
You should consider having a smear test regardless of your sexual orientation sexual history or whether you have had the HPV vaccine.
What do the cervical smear test results show?
A cervical smear test is a screening test, to detect abnormal pre-cancerous cells in the cervix (the opening of the womb from the vagina), at an early stage before it develops into cervical cancer.
Sometimes your doctor might ask you to come back in 3-6 months and have the test again. You do not need to be concerned about this. It usually means that the results were unclear because not enough cells were collected , or there is a little infection and so another smear test needs to be carried out. 2 in 100 tests are inadequate.
In the UK the first-line test in a cervical smear now checks for the presence of Human Papilloma virus (HPV) which is cause of the development of abnormal cells .
Negative smear test results
If you are negative for HPV, then no further tests on that sample need to be carried out. This is because if the HPV test is negative, the risk of you developing cervical cancer is very low, that you can go back to your 3 or 5 yearly screening tests.
To be reassured 93 in 100 routine cervical smears are normal.
Positive smear test results
When our smear test result is positive, it is easy to get worried but it is not always a cause for alarm. Approximately 6 in 100 tests are reported as abnormal. In the vast majority of these cases, this does not mean cancer. It usually means you just need local treatment to the cervix in clinic which will revert your smear test to normal
It is important to understand what having human papillomavirus means and what are the proactive step to take.
Cervical cancer occurs, when cells in the cervix become abnormal and continue to grow in an uncontrolled manner forming a lump (called a tumour). As the tumour grows, it can spread to other parts of the body and become potentially life-threatening.
Cervical cancer it is only the fourth most common cancer in women worldwide , but one of the most preventable because of the cervical screening program.
Positive smear test results / high-risk HPV
If you have a positive smear test / high-risk HPV you will be asked to come in for a more detailed assessment of your cervix by a gynaecologist with a special interest in this area, called a colposcopist.
During a colposcopy examination in the clinic, the cervix will be looked at in more detail, and abnormal cells can be biopsied, and treated/ removed with freezing, laser or cutting them away (loop excision).
Even in this case, although it might sound worrying , it is important not to rush to conclusions and follow your gynaecologist advice as this treatment can remove pre cancerous cells and revert smear tests to normal.
What is the human papilloma virus (HPV)?
It is important to note that nearly all cervical cancers are caused by a type of wart virus called the human papilloma virus (HPV). This virus is very common. At some point in our lives, 4 out of 5 (80%) of us will get at least one type of HPV. It is spread through very close skin to skin contact during any type of sexual activity with a man or woman.
( Please note that having a positive HPV result does not mean your partner has had sex with someone else while you have been together).
In most cases your immune system helps you to get rid of the virus, and it is thought that around 90% of HPV infections clear within 2 years. You will most likely not experience any symptoms of HPV infection, and so you may not even know you have had it.
You are at risk of getting HPV from your first sexual contact, whatever that is – it doesn’t have to be penetrative sex. You can be infected with HPV for a long time therefore without knowing about it, and so it is hard to find out when you became positive for HPV or who you got it from.
Cervical screening (a smear test) can find a high-risk HPV virus and changes early, before it develops into cancer.
You might have HPV even if you have not been sexually active or not had a new partner for many years.
HPV vaccination is highly recommended in both men and women, especially at a young age. In fact, there are 2 HPV vaccination available in England. The vaccination is given to boys and girls age 12-13. Adults can also have the vaccination but discuss this with your doctor ..
The vaccine is effective at stopping people getting the high-risk types of HPV that cause cancer, including most cervical cancers and some anal, genital, mouth and throat (head and neck) cancers.
How often do I need to have a smear test?
All women with a cervix aged 25-64 years, will be invited for a smear test by letter.
If you are between 25 and 49 you are invited to do your smear test every 3 years on the NHS , however, for your peace of mind and taking, even more, a proactive control on your health, you may want to have it once a year. Also, If you have symptoms such as irregular bleeding or bleeding after intercourse or previous abnormal smears you may need to have the test at more frequent intervals.
If you want to do your smear test you can either contact your GP or a private clinic and follow the guidance and advice given by your gynaecologist.
Should you have a smear test after 50 and 65?
Screening usually stops at the age of 65 years, unless you previously had abnormal smears. If it is reassuring, you can keep doing it even after that age.
From ages 50 to 64 years is recommended every 5 years on the NHS but you may wish to have this more frequently privately. If you have symptoms eg irregular bleeding or bleeding after intercourse you should report to your GP as you may need to have this more frequently.
It is important to note that cervical screening does not stop simply due to age until a woman who has previously had abnormal smears, then has had three negative results.
What to do before your smear test?
Before attending your smear test it is recommended you:
• Avoid intercourse, douching, or using any vaginal medicines or spermicidal foams, creams or jellies for two days before having a smear test, as these may wash away or obscure abnormal cells.
• Try not to schedule a smear during your menstrual period. It’s best to avoid this time of your cycle, if possible.
Does a smear test hurt? What to expect:
Some women may avoid attending this life-saving test because they feel it may be painful or hurt. This is a myth. This is what will happen:
After a quick chat with the health care professional, you will be asked to lie on the examination couch with your knees bent and your legs apart.
A small plastic speculum is gently inserted by the doctor / nurse (using lubricating KY jelly) into the vagina. It shouldn’t be painful, but you may feel some pressure and discomfort in your pelvic area
A small brush is used to take some cells from your cervix and is transferred to a container holding a special liquid to preserve the cells.
The samples are then transferred to a lab where they are examined under a microscope. It won’t last more than a few minutes in total!
What are red flag symptoms you should report immediately to your doctor?
As said, is recommended to attend the smear test every 3-5 years, however it is important to keep listening to our body.
Things may change quickly and you might show some symptoms which if experienced, should be reported to your doctor:
- Bleeding in between your periods.
- Bleeding after sex
- Sudden onset of heavy irregular periods
- Unusual vaginal discharge
- Pain during sex
How can I book my smear test today?
We really hope after this reading you could appreciate the power and value of this test and you are looking forward to having yours done soon.
You can book your appointment today by calling your GP or you can book here your smear test at our Centre.
This article has been written by Dr Zahra Ameen Consultant Obstetrician and Gynaecologist at The Women’s Wellness Centre.
Our Consultant Gynaecologists at The Women’s Wellness Centre offer a range of services dealing with female health concerns. If you wish to know more about our Private Gynaecology Services, please contact us on 020 7751 4488 or book an appointment online here.
Dr Zahra Ameen
Consultant Obstetrician and Gynaecologist BSc MBBS MRCOG
Dr Zahra Ameen is an experienced Consultant Gynaecologist with over 10 years clinical experience. Zahra’s special interests include ambulatory gynaecology, and acute gynaecology and early pregnancy scanning. Her skills include expertise in ultrasound scanning, management of general gynaecological conditions, management of miscarriage, and outpatient hysteroscopy. She is passionate about global health, having worked with and consulted for the WHO in Geneva, making Zahra an advocate for women’s health education and rights.