Q I’m a middle-aged woman worried about all the things in the newspaper I’ve been reading about cervical cancer. I’m not due another smear test under CervicalCheck for another three years, but I’m worried about what might be developing in the interim period. Would you recommend women should have a yearly, private check?. Also, I’ve been reading that GPs in Britain are going to be sending out self-sampling kits to women, and that you can buy HPV tests online. Can you tell me how they work and if that is something you would recommend?
Dr Nina replies: The recent controversy surrounding the CervicalCheck programme has caused many women distress. CervicalCheck is our national cervical cancer-screening programme. It invites all women aged 25 to 60 to attend their GP for a cervical smear. Many women are fearful of these tests, but there is no need to be. A smear simply involves taking a brushing of cells from the neck of the womb. A device called a speculum is inserted into the vagina to open it slightly and allow the smear taker to view the cervix. The insertion of a speculum can be associated with a feeling of pressure in the vagina, but it should not be painful. The taking of the smear itself is completely painless.
Smears are recommended every three years from the age of 25 to 44 and every five years from 45 to 60. If you have and abnormal smear, you will be checked for the HPV virus. If you are HPV positive and have had abnormal smears, you may require earlier smears and a closer follow up.
It is important to remember that screening is for otherwise healthy individuals. Anyone who has unusual symptoms — such as unexplained pelvic pan, pain during sex, bleeding between periods or after sex, or unusual unexplained vaginal discharge — requires a gynaecological exam. A smear or colposcopy outside the normal screening protocol may also be warranted.
An abnormal smear does not mean you have cancer. Most abnormalities found on smears are totally treatable. About one in 20 women who are screened will have some abnormal cells found. Less than one in 1,000 women who are referred for colposcopy are found to have cancer that requires immediate treatment.
‘Normal’ is a very reassuring result. Your next smear is required in either three or five years’ time, depending on whether you are under or over 45.
If you have attended regularly for smears since age 25, have no unusual symptoms and are otherwise well, you should feel very reassured by your normal smear.
It is possible to attend your GP and have a smear sent to a private lab, but this testing is down to personal choice and is not something that GPs are
If you are feeling very anxious about your risk of cervical cancer, you have the option to request HPV testing through the private labs. This testing is due to be introduced as part of CervicalCheck and will be a welcome development for doctors and patients alike.
Although home self-testing kits sound convenient, the accuracy of the test is the most important factor to consider in any screening test. We are not routinely advising this test.
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