Please note that some of the language in this article is sexually explicit.
Cervical Screening in the UK is one of the NHS success stories and has saved many British women from cervical cancer. The programme was set up in 1964 and its aims were to detect pre-cancerous changes in the cervix (the neck of the womb).
Who is eligible?
Women aged 25-64 are eligible for the test which is free and is done every three to five years. Women who are younger than 25 are not included on the list as it is rare for cervical cancer to develop at an earlier age.
If you are aged 25-49 the screening should at three yearly intervals, and aged 50- 64 every five years. After 65 women who have had three clear tests are removed from the recall list as the chances of contracting cervical cancer is greatly reduced.
Advice for preparation for the cervical smear test:
- You are advised not to have had sexual intercourse prior to the smear as sperm lubricants and spermicidal creams may alter the results.
- Do not use menopause vaginal oestrogen creams or pessaries prior to the test. If you are using either of these inform the practitioner who is doing the procedure.
- If you have had pessary treatment for a vaginal infection like Thrush it is advised to wait for a week before having your smear taken.
- Do not use a tampons for the week before the test
The procedure for the cervical smear test:
The test itself is more of a slight discomfort and to some ladies an embarrassment, but it is a life saver. The test will be undertaken by either a nurse or doctor.
- You will be asked to undress below the waist if you are wearing a skirt this can be lifted up.
- You will be asked to lie back on an examination table and given a blanket or sheet to cover your lower body
- You will be asked to draw you knees up and place your heels together and let you legs relax apart
- A speculum will be then placed in the entrance to the vagina and then moved inside the vagina this can feel unusual.
- The speculum is opened up which gives the practitioner a good view of the cervix, this may feel uncomfortable but should not hurt.
- The practitioner will then use a thin spatula or a tiny brush to remove a few cells from the cervix which will be placed on a slide or in the tube (LBC- liquid based cytology.)
- The speculum will be removed and the test is complete the slide/LBC will be examined under a microscope in the laboratory and the results will be sent to you.
All women should receive written confirmation of the results of their smear test within six weeks if you do not receive written confirmation of your results it is advisable to contact your surgery.
If abnormal cells are found you will be informed and an appointment with a gynaecologist will be made, or your smear test repeated; with the new LBC testing this should reduce the need for retests. Abnormal cells can return to a normal appearance but if untreated may develop into cancer. The gynaecologist will examine your cervix more closely and as a result of their findings will discuss with you the options available. Early treatment has prevented hundreds of deaths in this country.
A study, commissioned by the World Health Organization and published in The Lancet in 2003 suggested that a woman's risk of cervical cancer can be increased if she uses the contraceptive pill, for extended periods of time. The studies indicated that using the pill for over ten years doubles the chances of cervical cancer.
Around 3200 women are diagnosed with cervical cancer every year in the UK.
The Lancet (vol 361, p 1159)
LBC liquid based cytology testing
This is the latest form of cervical screening which has been introduced to reduce the amount of re tests which had to be done by the traditional smear/slide test. It has been decided by NICE (National Institute for Clinical Excellence) that this test will be more accurate and at present is available in many of the leading hospitals.As at September 2006, of the 142 laboratories that process cervical screening samples 67 have fully implemented LBC and 35 are intending to implement LBC by March 2007.