Gynaecologic Cancer Awareness Month

20th, Sep 2019

September is Gynaecologic Cancer Awareness Month and with this in mind we want to help raise awareness on the importance of smear tests and help contribute to a future where woman have the best chance for survival by being diagsnosed at the earliest possible stage.

Smear tests are one of the best and most accurate ways to protect yourself from cervical cancer. Yet, 1 in 4 woman do not attend their screenings at all. We spoke to Dr Lisa Neligan, one of our Private GP’s at Kingsbridge Private Hospital on the importance of cervical smear tests and what they involve.

WHY IS IT IMPORTANT TO HAVE A CERVICAL SMEAR TEST?

Cervical cancer is a disease that can often be prevented. Early changes can be detected in the neck of the womb (cervix), which indicate that cancer may develop. Since screenings started, the numbers of cases of cervical cancer have dramatically dropped, and so have the numbers of women dying from it.

Cancer of the cervix is now only the fourteenth most common cancer in women in the UK, whereas across the world it is the third or fourth most common cancer. This is because of the screening programme. It is one of the few types of cancer which can be detected and stopped before it ever begins.

HOW COMMON IS CERVICAL CANCER?

Cervical cancer is not uncommon. In recent years the number of cases has fallen due to cervical screening tests. It is estimated that over 4,000 women are prevented from developing cervical cancer every year in the UK, however, there are still around 3,000 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.

The cervical screening test is not a cancer test. The test is used to detect early abnormalities of the cervix which, if untreated, could lead to cervical cancer in the future.

WHAT HAPPENS WHEN ABNORMAL CELLS ARE FOUND?

In most women the cells that are taken are found to be normal. An abnormal result does not mean cancer in the vast majority of cases. Abnormal cells indicate that cancer may develop sometime in the future.

About 6 women in 100 will have an abnormal result that requires further testing or treatment. Most of these changes will not lead to cervical cancer. Treatment can be given to prevent cancer from developing in women with abnormal cells.

During each test some cells are removed from the neck of the womb (cervix), with a plastic brush. The cells are examined under a microscope to look for early changes that, if ignored and not treated, could develop into cancer of the cervix. If the test shows any abnormality, you will have treatment to stop you ever getting cancer of the cervix. So, an abnormal test usually does not mean you have cancer. It means you should have some treatment to stop you getting cancer.

WHAT IS DYSKARYOSIS?

Dyskaryosis is a medical term used to describe abnormal cell changes, seen with cervical screening. Dyskaryosis is not cancer. About 9 out of 10 cases of dyskaryosis revert back to normal on their own, without treatment. Nearly all abnormal tests show no more than small changes in the cervical cells.

Depending on the degree of abnormality (and the HPV test if it is done), women with abnormal results may:

• Need nothing further other than normal recall for another smear in the normal 3-5 years.
• Have a repeat cervical screening test at a shorter time interval.
• Be referred to a gynaecologist or to a colposcopy clinic for further examination of the cervix. Depending on the result of this examination, treatment may or may not be needed.

Borderline change is the mildest abnormality seen on cervical screening. About 3-4 in 100 results are borderline. Whilst the cells are not quite normal, they are not abnormal enough to be categorised as dyskaryosis.

Mild dyskaryosis is a common abnormal result from cervical screening. About 2 tests in every 100 show mild abnormalities of the cervical cells. Most of these changes go back to normal without any treatment.

Moderate or severe dyskaryosis shows up in even fewer women. About 1 in every 100 smear tests shows either one of these abnormalities. If your test shows moderate or severe dyskaryosis it is still very unlikely that you will have cervical cancer. The main difference is that these changes are less likely to return to normal by themselves. You will probably need some treatment, and this will happen at colposcopy.

Invasive or glandular neoplasia is a more serious abnormality which shows in less than 1 test in 1,000. Neoplasia means new growth of cells. Invasive neoplasia suggests cervical cancer might be present. This is not proven until a sample of cervical tissue (a biopsy) has been taken at colposcopy.

Glandular neoplasia is another significant abnormality that can be seen on cervical screening. It suggests that there is an abnormality in the lining of the womb (the endometrium), rather than on the cervix. This is because glandular cells (found lining the womb) are different to the ones normally found on the cervix. Glandular neoplasia again does not necessarily mean cancer, but cancer needs to be excluded. You will probably need to have a colposcopy and may need to have a small camera passed into the womb (called hysteroscopy).

WHAT IS THE PROCESS OF ROUTINE SMEAR TESTS?

First invitation for screening in the UK is at age 25.
Routine recall (repeat screening test) in the UK:

• Three-yearly tests from age 25 to age 49.
• Five-yearly tests from age 50 to 64.
• Screening stops at age 65.

Women over 65 years of age should be screened if:

• They have not had a cervical screening test since the age of 50.
• A recent cervical screening test has been abnormal.

Cervical screening does not stop simply due to age until a woman with a previously abnormal cervical screening test has had three negative results. 

HOW IS THE TEST DONE?

The cervix is the lowest part of the womb (uterus). It is often called the neck of the womb. It is inside a woman's vagina. You will be asked to remove your clothing from the waist down. If you wear a loose skirt, you may only need to remove your knickers. You will be asked to lie on your back on the examination couch. You should bend your knees, put your ankles together and let your knees fall open. A doctor or nurse will put an instrument called a speculum into your vagina. The speculum is put in while it is shut. The doctor or nurse then gently opens it. This opens the vagina and allows the cervix to be seen (at the top of the vagina). The doctor or nurse then uses a thin plastic stick with a small brush at the end to gently scrape some cells from the surface of the cervix. The cells that are obtained on the brush are sent away to be examined in the laboratory.

Please contact your GP if you have any concerns or any unusual vaginal bleeding.

Our Private GP Clinic is unique because where required, you can be referred to a Gynaecologist within the Kingsbridge Healthcare Group quickly. Our average waiting time to see a consultant is only 3.5 days.

You can book an appointment with one of our Private GP’s by contacting 028 9066 7878.

If you would like to get involved Ovarian Action Cancer are the UK’s Ovarian Cancer Research Charity who are taking action to make ovarian cancer a survivable disease.