Written by: Cally Worden
Cervical cancer is one of the few manifestations of this horrible disease that is preventable. Cervical smear tests are offered to all women between the ages of 25 and 64, every three-to-five years. Surely it’s a no-brainer? Pop yourself down to the Docs and get checked out. What could be simpler? Yet for many women the idea of a Smear Test is … uncomfortable. They put it off. And a small proportion of women pay the ultimate price for their reticence. Let’s de-mystify the whole thing right here, right now, and help every woman feel the fear and do it anyway.
Who Needs It?
Cervical cancer is not picky – it can form in any woman, and is most prevalent in sexually active women aged 25 and over. ‘Sexually active’ does not mean you are a nymphomaniac – it just refers to any woman who has sex from time to time. The cervical smear test is known to be very accurate at detecting abnormal changes in cervical cells before they have the chance to develop into cancer.
How Often is it Necessary?
Cervical smear tests are currently offered every 3-5 years in the UK. Women aged 25-49 years should be screened every 3 years. This screening interval extends to 5 years for women aged 50-64.
The success rate for detection of cervical cancer under this screening programme is compelling. In the 25-49 year age bracket three-yearly screening detects 84% of potential cancers before they have chance to develop. If you need a reason to make sure you get checked every 3 years, surely this is enough?
Where Can I get Tested?
Cervical screening is widely offered – you can get checked in the following places:
- Well-woman clinic
- Genito-urinary clinic
- Your GP’s surgery
- Family-planning clinic
- Private healthcare clinic
- Voluntary organisation clinic, such as a Marie Stopes facility
You can request that a female nurse or doctor conducts the test, and all male medical practitioners can be chaperoned by a female member of staff if that makes you feel more comfortable.
How is the Test Done?
In the privacy of the surgery you remove your underwear and lie on your back on the Doctor’s examining table, with your knees drawn up and spread apart. You can request to lie on your side with your knees drawn up if this is an easier position for you.
The Doctor or Nurse will insert a speculum to into your vagina. This is a smooth metal instrument that has two arms which can be gently spread to open up the vagina, giving your Doctor or Nurse a clear view of your cervix. The insertion can be a little uncomfortable, but it should not hurt. It helps if you can relax, keeping your vaginal muscles slack.
The Doctor or Nurse will then use a small, soft brush to gently scrape the surface of your cervix, collecting cells for analysis. The brush is immediately then placed into a small pot of liquid, and subsequently sent to a laboratory for testing. The speculum is removed slowly, and you can get down from the couch and get dressed.
The test results will be returned to your Doctor, who will usually only contact you if there is a problem.
What do the Results Mean?
- Retest Required – this may be because there was a problem with the sample taken, you had an infection your were unaware of that interfered with the results, or perhaps your period had not finished fully
- Borderline – this indicates that some cell changes were detected, but were so small that they may just be normal cell fluctuations that occur in this part of the body. You will probably be asked to go for retest in about 6 months time
- Cervical Erosion or Ectropion – this is generally nothing to be concerned about, and is thought to be unrelated to cervical cancer. It is to do with glandular cells normally only present inside the cervix, which can appear on its outer surface causing the cervix to seem inflamed. Common in adolescent girls, those women on the pill, and pregnant women, this condition can cause light bleeding but usually clears up by itself
- Abnormal Results – cell changes have been detected. These may be mild, moderate, or severe, but DO NOT mean you have cervical cancer. It means that abnormal cell changes have been detected, and if left untreated MAY develop into cancer. This is your red flag, and the reason why you have attended the screening in the first place
Depending on your abnormal results, the Doctor may order a biopsy, where a more significant cell sample is taken for analysis, and/or a colposcopy, where a more detailed examination of your cervix is undertaken. You may then be advised to have treatment to remove the abnormal cells, and this can take a number of different forms depending on the location, nature and severity of your symptoms.
Detection rates are not infallible – some cases do get missed, or treated incorrectly. But these instances are very very rare. No medical test is perfect, but that is not a good reason to reject it out of hand.
The Bottom Line?
The bottom line is that you need to look after your front bottom ladies. I lost my Dad to cancer and because of that have always steeled myself to get checked, even though I found it desperately embarrassing the first few times. After pregnancy and the birth of my two kids any remaining blushes I may have harboured had been completely eradicated. Lying with your legs spread in front of a stranger may never sit comfortably with you, but I promise you that a few short minutes of embarrassment in front of a healthcare professional who has seen more vaginas than you can shake a stick at are worth it for peace of mind.