The NHS screening programme was introduced in the 1980s, and now invites women aged 25 to 64 for a smear test every three to five years. It’s thought to save more than 5,000 lives every year.
Nevertheless, screening relies on people attending their smear test, and the latest NHS figures show that nearly a third of women don’t respond to their invitation.
Understanding what cervical cancer is, the role of screening, and how to spot the signs and symptoms is key in helping more women beat cervical cancer.
What is cervical cancer?
Cervical cancer is cancer of the cervix, the opening at the very top of the vagina, leading to the uterus. Abnormal cells start to grow out of control and can form a tumour.
Who gets cervical cancer?
Anyone with a cervix can get cervical cancer. It’s most common in younger people between 30 and 45.
What causes cervical cancer?
HPV is a major cause of the main types of cervical cancer.
HPV (human papilloma virus) is actually very common. For most people the virus causes no harm and goes away on its own – but if your immune system isn’t doing the job, a persistent infection can develop and can increase your risk for cervical cancer.
The good news is there is now an HPV vaccine that’s given to school-age girls, and protects against the types of HPV that are most likely to cause cervical cancer.
Other potential risk factors include a family history of cervical cancer, a history of other sexually transmitted diseases, smoking, having HIV, taking the oral contraceptive pill - and even how many children you’ve had and what age (your risk is higher if you had a baby before the age of 17, for instance).
In general, people can lower their risk by minimising genital skin contact and using condoms, and doing general things to boost their immune system - like eating well, exercising, drinking less and giving up smoking.
What are the main symptoms of cervical cancer?
Early cervical cancers and pre-cancerous abnormal cells in the cervix often won’t have any symptoms at all – which is why smear tests are so important.
As the cancer progresses, women might notice:
- Vaginal bleeding that's not normal for you – for instance bleeding during or after sex, between periods or after the menopause, or having heavier periods than you usually do
- Changes to your vaginal discharge – particularly if it’s heavier or has an unpleasant odour
- Pain during sex
- Pain in your lower back, lower stomach, or between your hips.
These symptoms don’t necessarily mean you’ve got cervical cancer. They could also be symptoms of other issues like endometriosis, fibroids, or cervical erosion. But it’s really important to see your GP if you notice this sort of change – just to get it checked out.
What is a smear test?
A cervical screening test or ‘smear’ test is a cervical screening test where a sample of cells is taken from your cervix, and sent off for analysis. It’s looking for the HPV virus, and for any cells that are starting to become ‘abnormal’ – showing the sort of changes that can go on to become cancer.
What happens in a smear test?
The test is usually done by a female nurse at your local GP surgery. They do hundreds of these tests, and are really good at putting you at your ease if you’re feeling nervous.
You’ll be asked to remove your clothes from the waist down and lie down, with your legs drawn up and spread apart at the knees. You can wear a dress or long top, and you may also be given a sheet or length of paper to cover up with.
The nurse then uses a smooth plastic tool called a speculum with a bit of jelly on it, which goes into your vagina and opens up to give them a clear view of your cervix. It can be slightly uncomfortable but isn’t usually painful. Try and breathe normally and relax as much as possible.
Your nurse then takes a soft brush or swab to collect some cells at the top of your cervix, and puts the swab into a plastic tube to be sent off to the laboratory. The speculum is removed, and you can get dressed and go home. The whole thing usually takes less than 5 minutes.
When do you get the results?
Your results will normally come through in about 4-6 weeks, by letter.
This will tell you if any HPV virus was detected. If your test was negative, you’ll be invited back in another 3-5 years. If it was positive, they will also test your sample further for abnormal cells.
What happens if you do have abnormal cells?
If there are cell changes, you will be invited for further investigation.
This will be with a specialist at a hospital, who will want to do things like blood tests and a colposcopy – a procedure that looks even more closely at your cervix. They may also want to do a biopsy, where a further sample of cells is taken, or an MRI scan. This will help them determine if you have cervical cancer, and what stage it is if you do.
If you have abnormal cells which are pre-cancerous, these may be treated through loop excision of the transformation zone (LLETZ), which can also be used to help diagnose cervical cancer. Your colposcopist uses a thin wire loop to remove the ‘transformation zone’ – the area around the opening of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.
If you’re given the all-clear after further tests, you will still be invited back for early screening one year later, just to check things are still looking good.
If cervical cancer IS found, your specialist will help you work through the right treatment plan for you.
How is cervical cancer treated?
Cervical cancer is usually treated through some combination of chemotherapy and radiotherapy, and possibly surgery to remove part or all of the uterus. It will depend how early your cancer has been caught, and how fast it’s thought to be growing and spreading.
The good news is that survival rates for cervical cancer are really good. Half of those diagnosed with cervical cancer in the UK will live for ten years after their initial diagnosis.
How can Equipsme help?
Equipsme plans do not cover the private treatment of a diagnosed cancer condition but we can still help if you have symptoms that you do not know the diagnosis for yet – and need to speak to someone to try and find out faster.
All plans come with GP access, which means that if you can’t get an appointment with your own GP, or if you want a second opinion, you’ve got another option. Too many women are dismissed as ‘just’ having IBS or period pain, and with Equipsme you can often get help sooner if you don’t feel you’re getting the right attention.
If a GP provides a referral to see a specialist, those with diagnosis cover as part of their plan can also ask if their condition is covered and, if so, get to see a specialist more quickly. The NHS is brilliant when it comes to cancer treatment – so the faster you get your diagnosis the easier it may be to get treatment back in the NHS, and that’s what Equipsme can help with.
How can I find out more about cervical cancer?
UK Cervical Cancer
Jo’s Cervical Cancer Trust