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25 March 2019
The facts about cervical screening
Cervical screening – or smear test – is the best way for women to protect themselves against cervical cancer. Since the screening programme was introduced in 1988, deaths from cervical cancer have fallen significantly.
Despite this success, the number of women attending screening appointments is at 20-year low, which means many women could be putting themselves at risk from developing cervical cancer. Several barriers have been identified as to why this is; these range from fear and embarrassment to a misunderstanding of what cervical screening is. So in this blog I intend to answer the most frequently asked questions and try to ease anxieties about cervical screening.
I don’t feel ill and have no discharge or any other symptoms that could indicate I have cervical cancer, so why do I need to be screened?
Cervical screening is not a test for cancer. It tests for abnormal cells in the cervix (the lower part of the uterus or womb) which can potentially cause cancer. If abnormal cells are detected they can be treated which will stop cancer from developing.
I’ve had the HPV vaccination, so doesn’t this mean I’m protected against cervical cancer and don’t need to be screened?
This is a common misunderstanding among younger women, but the answer is no. Most cervical cancers are caused by the human papillomavirus (HPV). And although the vaccine protects against 70% of HPV, there are other types of high-risk HPV which the vaccination doesn’t offer protection against. Cervical screening can help find a high-risk HPV infection or changes to cells (abnormalities) early.
What does cervical screening involve?
It involves using an instrument called a speculum to open the vagina, so that the cervix can be seen. A small, soft brush is then used to quickly remove sample cells from the cervix. This can feel a little strange but it doesn’t take long. If it’s your first cervical screening appointment your GP or nurse will explain exactly what will happen and answer any questions you may have.
I’m embarrassed to attend because of the intimate nature of the screening.
There is no need to feel embarrassed about attending a cervical screening appointment. If you would prefer it to be carried out by a female doctor or nurse, talk to your GP practice to see if this is possible. All doctors want to encourage women to take part in the cervical screening programme, and will do what they can to put you at your ease.
What if I’m having my period at the same time as my screening appointment?
Always try to arrange your appointment for the middle or towards the end of your cycle. Being screened during your period can affect the test.
Will it be painfuI?
Screening should not be painful and if you experience any pain you should tell your doctor or nurse immediately. It can feel a little uncomfortable but this can be reduced by adjusting position. Generally, the screening procedure takes place with the woman on her back, but it can be carried out with you lying on your side and some women have found this position to be less uncomfortable. Once again, talk to your doctor or nurse if you are experiencing any problems during the screening procedure.
I’m frightened that the test will find that I have cancer.
There is nothing to be afraid of as screening is designed to prevent cancer developing. The majority of women who are screened have normal test results. Those who do have a positive result have not been diagnosed with cancer; they’ve been found to have abnormal cells that can be treated to stop cancer developing. The cervical screening programme is all about prevention.
Should I be screened during pregnancy?
Generally, women should not be screened during pregnancy. If your last screening before you became pregnant was negative, you should wait for three months after the birth of your baby before making a screening appointment. However, if your last screening was positive, then your GP may advise you to have a screening during pregnancy.
Since the menopause I’ve found screening to be very uncomfortable so don’t bother going.
After the menopause some women report experiencing discomfort due to vaginal dryness and are put off attending their screening appointments. But your GP can prescribe vaginal oestrogen four weeks before your screening appointment which will help ease any discomfort. Other intimate moisturisers are available but always discuss the possibility of using these with your doctor
Nearly 700 women die in England of cervical cancer every year. It is estimated that 83% of these deaths could be prevented by cervical screening. NHS England advises all women aged between 25 and 64 to take part in the screening programme. Those between the ages of 25 and 49 should be screened every three years, while those aged 50 to 64 every five years. If you missed your last screening appointment, contact your GP surgery today.
Dr Saheli Chaudhury
Bedfordshire Clinical Commissioning Group Macmillan Cancer Lead GP