Here's why you should book your smear test sooner rather than later
New Victoria Hospital’s leading Consultant Gynaecologist Mr Andrew Pooley separates the myths from facts when it comes to smear tests.
Research suggests that over half a million cervical cancer screenings (smear tests) may have been delayed or cancelled over the last year due to COVID19 and with fears growing around attending appointments, the temptation to avoid them altogether is greater than ever.
According to leading cervical cancer charity Jo’s Trust, attendance is plummeting at an alarming rate, with only half of eligible patients attending their smear test in some parts of the UK. Despite up to 93% of cervical cancers being preventable through proper screening, many people put off booking appointments due to fear (71%), body self-consciousness (67%) or embarrassment (81%).
As it is Cervical Cancer Awareness Week, New Victoria Hospital’s leading Consultant Gynaecologist Mr Andrew Pooley is keen to discredit some of the myths surrounding cervical screening, as well as highlight some of the key facts around the process of attending one. “It is estimated that the smear test program, with proper treatment of the pre-cancerous changes that are sometimes found, saves the lives of up to 5000 women per year, who would otherwise have died of future cervical cancer. The smear test does not prevent pre-cancerous changes, but it does find them at an early and simply treatable stage in nearly all cases.
“Being armed with the correct facts is vital when it comes to health, so it’s important for people to understand exactly why smear tests are so important and what the process of going for one really involves.”
That a screening will test you for cervical cancer itself
Screenings shouldn’t be seen as a judgement day of whether you have cervical cancer or not. When attended regularly, they help with the monitoring of a change in cells and the detection of pre-cancerous ones – something that is easily treatable and helps stop the development of cervical cancer.
“The modern screening test is looking for possible presence of certain strains of the Human Papilloma Virus (HPV), not for cervical cancer itself,” explains Mr Pooley. “If HPV is found, then the cells in the test are examined for possible signs of pre-cancerous cells, which, if found are very simply treatable in nearly all cases.”
That it tests for other types of cancer at the same time
A smear test isn’t a one-stop-shop for all types of Gynaecological cancers but, assures Mr Pooley, it can pick up on other infections that may have gone unnoticed. “Unfortunately, the smear test cannot detect signs of other more rare gynaecological cancers, though it can sometimes usefully detect signs of some common vaginal infections.”
That you don’t need a smear test if you’re not sexually active
Sexual inactivity does not prevent the development of cervical cancer. “If a woman or a person with a cervix has ever had any form of sexual contact another person of any gender, however long ago, then they should attend for smear tests when called to, as they are at risk of cervical smear problems,” says Mr Pooley.
That it always hurts
One of the biggest fears people have around attending smear tests is the pain it might cause. However, as Mr Pooley explains, this can be prevented: “The large majority of smear test visits are recalled mildly uncomfortable, but not painful. It is always sensible to discuss one’s concern about possible discomfort with the person taking the smear so that options can be taken to try to minimise any discomfort.”
That it has to be embarrassing
“It is clearly somewhat strange to undergo such an examination, but every step should be taken to minimise embarrassment,” reassures Mr Pooley. “It is sensible to wear certain clothing such as a skirt or long top. You should be able to actually undress and dress again after the test while preserving your dignity. You can request a chaperone, or even request that a friend accompany you if that might help.”
That you don't need them ever again if you've had the HPV vaccine
A worrying misconception about the vaccine routinely offered to teens since 2008 is that it completely protects you from cervical cancer. “It is just as important to have routine smear testing even if you have had the HPV vaccine,” stresses Mr Pooley. “It is likely that the chance of ever having cervical cancer will be much lower in those who have had the vaccine, but some types of cervical precancerous changes will not be prevented by the vaccines and are just as treatable if detected.”
The new surge in COVID-19 cases will affect appointments
Unlike in the first lockdown, routine screenings are carrying on as normal. “Routine screening and colposcopy clinics were suspended during the height of the first but these services were reinstated in late spring of 2020 and are still continuing as normal. As it stands, no intention to suspend routine screening has been announced for this lockdown.”
How long the test takes
“The visit usually takes a total of 10 minutes, with 5 minutes for the actual test itself, with all the consideration of the patient’s possible physical and psychological discomfort as above.”
The importance of attending screenings
Screenings, as mentioned, help foresee potential issues and eradiate them before they develop. “Up to 25% of those contacted to make a smear test appointment do not do so or delay it for months or years. Some of those will end up needing more complex treatments, and some will have developed cancer that would have been preventable with earlier identification and treatment of pre-cancerous changes. Some will sadly die as a result of their cervical cancer.”
The process and accuracy of results
“Currently the results of HPV smear tests are available in 2-3 weeks, though communication of the result may vary from area to area,” says Mr Pooley. “If the result is positive for HPV, and abnormal cells are found (roughly 20 in every 1000 tests) then a referral is automatically made for a colposcopy examination in the local hospital clinic. The screening for such changes is highly accurate with possibly 2 per 1000 cases of pre-cancerous changes being missed, by the smear test and colposcopy program.”
For more information about New Victoria Hospital’s Cervical Screening Program, visit the website here.