June 20-26 sees cervical screening week. As a preventative measure for cervical cancer, vaccination against the HPV virus has proven highly effective. But does this mean you no longer need your regular smear test? Find out about cervical cancer screening, vaccination, and what it means for you.
Cervical cancer statistics:
According to Cancer Research UK, around 9 women a day receive a diagnosis of cervical cancer, and around 850 women die annually from the disease. That means around 1 in 142 females in the UK will be diagnosed with cervical cancer in their lifetime. However, 99.8% of these cases are preventable.
Cervical screening became a part of NHS services in 1988. Thanks to regular screening, rates of cervical cancer fell by around 25% between the early 1990s and the late 2000s. Since then, they have remained largely stable. But the number of new cases is predicted to fall again over the next few decades, with the introduction of the HPV vaccination programme.
The risk of developing cervical cancer depends on many things. Some of these things are unavoidable, such as genetics. However, some factors are preventable. For example, 21% of cases in the UK are caused by smoking. And 99.8% are caused by infection with a virus called ‘human papillomavirus’ (HPV).
Screening (‘smear test’)
A smear test checks for the presence of certain types of HPV, and if you have them, for abnormal changes in the cells of your cervix.
All people with a cervix, no matter their gender identity, can have a free smear test. Your GP surgery will invite you for a smear test if you’re aged between 25 and 64. You’ll then be invited yearly, or every three or five years, depending on the results of your previous tests. Or your doctor may suggest further tests, such as a colposcopy.
It’s best not to have a smear test if you’re pregnant or during your period, as the test results are often unclear. Let your GP or nurse know if you think you may be pregnant. In some cases, your doctor may advise you to have a test whilst pregnant, if a previous test suggests you need a follow-up. This is nothing to worry about and won’t affect your pregnancy.
What happens at a smear test?
The test is usually performed at your GP surgery by a trained nurse. The nurse will give you privacy to undress from the waist down. If you prefer, wear a loose skirt. You can keep this on and just remove your underwear.
You will then lie down, either on your back or on your left side, with your knees bent. The nurse will gently insert a plastic or metal cylinder, called a ‘speculum’, into your vagina. Speculums come in different sizes, so if it’s uncomfortable, ask for a smaller one.
Once in place, it can be widened slightly so the nurse can see your cervix. The nurse will then gently rub your cervix with a soft brush. This collects a sample of cells from the surface of the cervix. The nurse will then remove the brush and speculum and allow you to get dressed again.
The whole process only takes a few minutes. Although everyone experiences things in different ways, most people report no more than a mild discomfort. Some people experience a little bleeding in the day or two afterwards.
The cell sample is then sent to a lab for testing. If there are any concerns, your GP practice will get in touch and explain what the next steps are.
There are several specialist cervical screening clinics in the UK. These are designed to help people who may find screening particularly difficult. My Body Back Project clinics are aimed at helping people who have experienced sexual violence access screening. CliniQ offer sexual health services for trans, non-binary and gender diverse people and have a trans-led team.
HPV vaccination programme
2008 saw the introduction of an HPV vaccination programme for teenage girls. It has taken some time to find out how effective it is, but research has had some very promising results. One study showed that, amongst girls who had the vaccine aged 12 or 13, there was a 90% decrease in occurrences of cervical cancer when they were in their 20s.
At Woodside Clinic, we aim to provide you with the knowledge to make the best health choices for you. If you have any concerns about your health, we’re here to discuss options and, where necessary, we can refer you to your GP.