Cervical Cancer Prevention
Let’s face it, with all that’s been going on this past year, we’ve all been challenged to adapt to change and amend our priorities. However, one thing that hasn’t changed is the importance of attending our cervical screening.
According to American Cancer Society, around 14,100 women are diagnosed with invasive cervical cancer in the US each year, that’s more than 38 cases diagnosed every day 1 . But the disease is preventable with vaccination and appropriate screening 2.
Cervical Cancer Awareness Month
January marks Cervical Cancer Awareness Month, with the fifth annual HPV prevention week taking place 23-27th January 2023. This year, it’s more important than ever to help raise awareness of the condition and how to prevent it.
What is cervical cancer?
The cervix is the lower part of the womb (the uterus) and is also called the neck of the womb. It is the opening to the vagina from the womb. (The diagram below demonstrates its position in the body). Cervical cancer is when abnormal cells in the lining of the cervix grow in an uncontrolled way and eventually form a growth (tumour) 3. Cervical cancer can affect women of all ages, but primarily affects women aged between 30 - 45 years. It is rare in women under 25 4.
What causes cervical cancer?
Most cervical cancers are caused by a sexually transmitted infection called human papillomavirus (HPV). Approximately 80% of people will experience HPV at some time in their life, but it usually clears up on its own without the need for any treatment. However, if the body is unable to clear the virus, there is a risk of abnormal cells developing which could become cancerous. HPV is usually spread through skin-to-skin sexual contact, meaning that it does not require penetrative sex to be transmitted 5. It can be transmitted though oral, vaginal or anal sex and using sex toys. Practising safer safe with a condom can help to reduce your risk of developing the infection.
What are the symptoms?
According to cervical cancer charity Jo’s Trust 6, common symptoms of cervical cancer include:
- Vaginal bleeding that is unusual for you, i.e. bleeding between periods, after the menopause or after sex
- Pain or discomfort during sex
- Change to or unpleasant smelling vaginal discharge
- Unexplained pain in your lower back or pelvis
If you do experience these symptoms, it doesn’t mean that you definitely have cervical cancer but the NHS 7 recommends that you see your GP as soon as possible to check them out.
The most important things you can do to help prevent cervical cancer are to get vaccinated against HPV, have regular screening tests, and go back to the doctor if your screening test results are not normal.
Cervical cancer prevention – HPV vaccination
The HPV vaccine protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. HPV vaccination is recommended for preteens aged 11 to 12 years but can be given starting at age 9. HPV vaccine also is recommended for everyone through age 26 years, if they are not vaccinated already.
HPV vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination 8.
The vaccine is designed to significantly reduce the risk of cervical cancer, but even if you have had the vaccine, it is still important to attend your cervical screening. The vaccine does not guarantee immunity from the condition.
Cervical cancer prevention - Cervical screening
Attending a smear test or cervical screening is one of the best ways to prevent cervical cancer developing or progressing. A cervical screening (or smear test) is an examination by a nurse or doctor to look for abnormal cells that could potentially turn into cancer. The test itself doesn’t test for cervical cancer but can identify abnormal changes to cervix cells at an early stage.
The American Cancer Society recommends cervical cancer screening with an HPV test alone every 5 years for everyone with a cervix from age 25 until age 65. If HPV testing alone is not available, people can get screened with an HPV/Pap cotest every 5 years or a Pap test every 3 years. For more information see the ACS website here.
Attending a cervical screening isn’t something that most people look forward to, but it’s important to attend your test as the potential benefits far outweigh any minor embarrassment. Gynecological cancer charity, The Eve Appeal states that the screening programme is estimated to save over 4,000 lives each year 9.
What happens during your smear test?
You will meet your nurse/doctor who will ask you to go behind a curtain and get undressed from the waist down, covering yourself with a sheet of medical paper. Once ready, your nurse will ask you to position yourself with your hands under your pelvis to raise your hips and then spread your knees. The nurse will then apply a small amount of lubricant and insert a speculum (an expanding plastic tube) into the vagina to be able to see the cervix and then use a little plastic brush to extract the cells. It can be a little uncomfortable when the speculum is inserted but this is over very quickly. Top tips: You can bring someone into the room with you as a chaperone. Did you know that speculums come in difference sizes? You can ask for a smaller size speculum during your examination if you wish.
How long does it last?
The appointment is usually around 20 minutes, the procedure itself is over quickly, lasting 3 minutes.
When can I expect my results?
After the cells are extracted and sent off for testing, your results will be returned in around 2 to 6 weeks.
Can I take my own lubricant with me?
Some people like to take their own lubricant to a screening. However, it is worth noting that more research needs to be conducted to rule out a lubricant affecting the test results, so do speak to your nurse or doctor about this first. It’s recommended that you avoid using a spermicide or oil-based lubricant 24 hours before the test as these can affect the result (9). For women experiencing dryness or atrophy, some nurses recommend the use of a vaginal moisturiser or vaginal oestrogen for 14 days before the test but make sure you stop this treatment 24 hours before the test.
Cervical Cancer Resources
You can find more information on Cervical Cancer using the following resources:
The Eve Appeal Website
The National Cervical Cancer Coalition (NCCC)
Jo’s Trust Website
Cancer Research UK Website
CDC – what can I do to reduce my risk of cervical cancer?