Pap Smears & HPV Vaccines: Everything you need to know about Cervical Cancer Prevention
Let’s be honest, life can get pretty busy. In recent years more than ever we’ve all had moments where we’ve been pressed to reconsider our priorities. One thing that hasn’t changed however, is the important of attending a smear test, also known as a cervical screening.
According to American Cancer Society, around 14,000 women were diagnosed with invasive cervical cancer in the US last year, that’s more than 38 cases diagnosed every day [1]. The good news is the disease is preventable with vaccination and appropriate screening [2].
Whilst our focus is on intimate health all year long, January marks Cervical Cancer Awareness Month. A time where we want to get as many people informed and involved as possible. The World Health Organization has a plan for the elimination of cervical cancer through vaccination and screening. This January, we encourage everyone to understand cervical cancer and how it can be prevented.
What is Cervical Cancer?
Cervical cancer is cancer that starts in the cells of the cervix. The cervix is the lower, narrower part of the uterus (also called the womb). It is the opening to the vagina from the womb – see the diagram below to show 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 [3].
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 lives, but most times, our immune system clears this virus. However sometimes the body is unable to clear this, and 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 [4]. Practising safe sex with a condom can help to reduce your risk of developing the infection, as it can be transferred through oral, vaginal or anal sex, and through using sex toys.
What are the symptoms?
According to The National Cervical Cancer Coalition (NCCC) [5], common symptoms include;
-
Abnormal bleeding, such as:
- Bleeding between regular menstrual periods
- Bleeding after sexual intercourse
- Bleeding after douching
- Bleeding after a pelvic exam
- Bleeding after menopause
- Pelvic pain not related to your menstrual cycle
- Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor
- Increased urinary frequency
- Pain during urination
If you do experience these symptoms, they could also be signs of other health problems, it doesn’t mean that you definitely have cervical cancer. You should speak to your healthcare provider to check them out [6].
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
Cervical Screening (Smear / Pap Test)
Attending a pap smear test or cervical screening is one of the best ways to prevent cervical cancer from developing or progressing. The test is an examination by a nurse or doctor to look for abnormal cells that could potentially turn into cancer. The screening 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.
Women older than 65 who have had adequate prior screening and are not otherwise at high risk are no longer advised to attend screening. Women who have had a hysterectomy (with removal of the cervix) also do not need to be screened, unless they have a have a history of a high-grade precancerous lesions [7].
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 [8].
What happens during a Pap 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 different sizes? You can ask for a smaller size speculum during your examination if you wish.
How long does a Pap Smear Test 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 estrogen for 14 days before the test but make sure you stop this treatment 24 hours before the test.
Can I attend a pap smear test on my period?
It’s best to have your cervical screening test when you’re not on your period. If you’re bleeding, the sample probably won’t be clear, and you may need to have the test again. Try to make an appointment before or after your period is due.
Can I have a pap smear test whilst pregnant?
You will not usually need to have cervical screening if you're pregnant, or could be pregnant, until at least 12 weeks after you've given birth. This is because pregnancy can make it harder to get clear results. A Pap Smear is usually done during your first prenatal visit. It poses no risk to the fetus and is a routine part of your prenatal care [10]. If the results come back showing an abnormality during your pregnancy, your doctor will discuss treatments that can be done safely during pregnancy, or depending on diagnosis, delay treatment until after your baby is born. Many times the birth of your baby will wash away any abnormal cervical cells [11].
Cervical Cancer Resources
Looking for more information on Cervical Cancer? See the following resources:
- National Cervical Cancer Coalition: nccc-online.org
- Lady Garden Foundation: ladygardenfoundation.com
- American Cancer Society: cancer.org
- Cervical Cancer Free America: cervicalcancerfreeamerica.org
- Cure Cervical Cancer.org: org
References
- https://www.cancer.org/cancer/types/cervical-cancer/about/key-statistics.html
- https://www.nccc-online.org/cervical-health-awareness-month/
- https://www.cancerresearchuk.org/about-cancer/cervical-cancer/getting-diagnosed/screening/about
- https://eveappeal.org.uk/gynaecological-cancers/cervical-cancer/
- https://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/
- https://www.nccc-online.org/hpvcervical-cancer/cervical-cancer-overview/
- https://www.cancer.gov/news-events/cancer-currents-blog/2020/cervical-cancer-screening-hpv-test-guideline
- https://eveappeal.org.uk/gynaecological-cancers/cervical-cancer/
- https://www.jostrust.org.uk/information/cervical-screening/what-happens-during-cervical-screening
- https://americanpregnancy.org/womens-health/pap-smear/
- https://americanpregnancy.org/womens-health/pap-smear/
