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The test every woman should go for

Prevention is better than cure - the cervical smear test.   2011-06-09
 

Our bodies are composed of cells. In the normal process of our lives, these cells grow, divide, become old, damaged and die to be replaced by new cells. Sometimes however, this process can go wrong, damaged cells do not die when they should and new ones grow when they should not be growing. These unwanted cells may form a mass of tissue called a tumour. Tumours may be non cancerous, known as benign or they can be malignant. Malignant tumours are cancerous and they can spread to other parts of the body. The cancer cells will continue to grow unless they are surgically removed or are treated with chemotherapy, radiation therapy, or any other recognised cancer treatment. Some cancers may disappear with no medical intervention but this is extremely rare.

All cancers are curable if caught early enough. Cancers caught at a later stage may also be curable and even if not, may certainly be treatable. It is safer however, to have the cancer diagnosed at an early stage and it is advisable that we all go to screening tests on a regular basis.

Cervical cancer

The cervix is the organ which connects the uterus with the vagina. Cervical cancer, as with any other cancer, begins to form in the cells of the tissue that make up the surface of the cervix and it is one of the most common cancers which affect a woman's reproductive organs.

As with other tumours, growths on the cervix can be benign or malignant. Benign growths such as polyps, cysts or genital warts are not cancerous and they do not spread. Malignant growths on the other hand, may spread and can be life threatening. When a woman is diagnosed as having a malignant growth in her cervix, she has cervical cancer. If left untreated, the malignant growth can invade more deeply into the cervix and neighbouring tissues. It may then begin to spread by breaking away from the original growth or tumour and entering blood vessels which branch into all the tissues of the body. The cancer cells may attach to other tissues and grow to form new tumours that may damage those tissues. The spread of cancer is called metastasis.

Cervical cancer is a slow growing cancer which may not have symptoms but can be found with a Pap test. A Pap test is the name given to the procedure in which cells are scraped from the cervix and looked at under a microscope. Cervical cancer is almost always caused by human papillomavirus (HPV) infection.

Cervical Screening Test

You do not go for a Cervical Screening Tests in order to diagnose cervical cancer. The aim of these tests is to make sure that your cervix is healthy. If it is found that cells in the cervix have gone through changes it does not mean that they will lead to cervical cancer. Cervical cancer can be prevented before it even starts developing so it is important that all women go for a test as directed by their physician.

Cervical Screening Test Results?

Cervical screening tests examine a sample of cells from the cervix. The test results can be reported as:

  • normal
  • inadequate, or
  • abnormal

Normal result

90% of all cervical screening tests are normal. What this means is that you have a low chance of developing cervical cancer. Obviously, this does not mean that cancer will not develop, what it means is that the chances are low.

You should always keep in mind that no screening test is 100% accurate. Some tests give false negative results, meaning that the given result is 'normal' but there is an abnormality or vice versa, it is therefore important to have tests regularly. Cervical cancer takes years to develop from the earliest abnormalities, so there should be plenty of opportunity to detect abnormalities before problems do develop. If you get a false positive result, a further examination will reveal that everything is normal.

Inadequate

Statistics show that about 2 tests in every 100 are inadequate and need to be repeated. Inadequate simply means no result can be given as not enough cervical cells were present for examination under the microscope. In the event that a woman has three inadequate tests in a row, the National Cervical Screening Programme advises that she be referred on for colposcopy examination.

Abnormal result

About 1 in 20 tests is reported as abnormal. There is a range of changes that may occur. This does not mean that you have cancer. What it means is that some cervical cells have gone through changes. Most such cells revert back to normal on their own, without treatment. Nearly all abnormal tests show no more than small changes in the cervical cells.

A woman who has received an abnormal result may:

  • Have a repeat cervical screening test at a shorter time interval.
  • Be referred to a Gynecologist or to a Colposcopy clinic - for further examination of the cervix +/- treatment. The urgency of this referral depends on the actual result of the cervical screening test.

It is important to remember that it is rare for an actual cervical cancer to be found on cervical screening. Remember that screening is designed to find early changes that could become cancer in the future, if left untreated.

Can abnormal cells be treated?

A minor abnormal change often goes away by itself. This is why a repeat test after 3-12 months may be all that is needed. If the cells remain abnormal, or the changes are more marked, then treatment is offered. This will stop cancer from developing in the future. Treatment, if needed, is simple and virtually 100% effective.

The NHS Cervical Screening Programme

The NHS Cervical Screening Programme is a free service which invites all women for regular tests. You need to be registered with a GP, as this is how the programme gets to you. It is therefore important that your GP has correct address details for you. The system is not foolproof however and mistakes and oversights can happen so if you are over 25 and you haven't received a first invitation or if it is more than 3 or 5 years (depending on your age) since you last had a test done, contact you GP.

Why is the cervical screening test important?

Cervical cancer is not uncommon. In recent years the number of cases has fallen due to cervical screening tests. However, there are still over 2,000 new cases of cervical cancer diagnosed each year in the UK. Most of these occur in women who have never had a screening test, or who have not had one for many years. Cervical cancer can be prevented if you have regular screening tests. It is estimated that up to 3,900 women are prevented from developing cervical cancer every year in the UK due to cervical screening.

Where do I go for a cervical screening test?

Most women have the test at their GP practice. It is usually done by the Practice Nurse. You can have it done at a Family Planning Clinic and Well Woman Clinic if you prefer. A copy of the result is usually sent to you, your, GP and the health authority - called the Primary Care Trust (PCT). This can take up to 6-8 weeks.