It’s been a while since I have written a women’s health post on Florenec Finds and as it’s Cervical Screening Awareness Week, now seemed like an excellent time to talk about one of those things we all probably dislike doing and might even put off. I’m going to write this in a Q&A style post and I’d love you to both spread the word and get involved if you have any questions – I’ll do my best to answer them throughout the day.
What is a Cervical Smear?
The ‘smear test’ is an examination for women in which cells are taken from the surface of the cervix and examined under the microscope. It is looking for any changes in the cells which may be pre-cancerous and enables early treatment or monitoring. As the cervix is hidden away at the top of the vagina, the test is done using an instrument called a speculum which holds open the vaginal walls for a better view of the cervix.
Who needs one?
All women, (that includes lesbians, nuns, people who have never been sexually active, those who have always used condoms etc etc.) over the age of 25 should have a smear. In normal circumstances it needs repeating every 3 years, but this may change if there is an abnormality. It will never be less frequent until you are over 50, when the tests become 5 yearly and stop at age 65.
Why should I have one?
Smear tests are looking for PRE-cancerous cells – that is cells that are showing signs of changing and that could potentially become cancerous. This is a golden opportunity to prevent cervical cancer ever occurring and potentially save your life.
What if they find a problem?
If abnormal cells are spotted on a smear test (under the microscope – pre-cancerous cells can’t be seen with the naked eye, but other problems can be,) they are separated into different ‘grades’ of severity and the treatment is arranged accordingly. In the most mild cases, it may simply require observation and a repeat smear in 3-12 months. This is because some changes that are seen on smear tests can go back to normal by themselves. Most abnormal findings however require a colposcopy – a test that is often done in hospital where in a similar way to how the smear is first done, the cervix is examined, and a special stain is applied to see if there are any problem cells. They are then sometimes frozen or burned off or cut out. That’s about as pleasant as it sounds but is a small procedure, relatively quick and should solve the problem.
Can I get a smear when I’m pregnant?
No. You can’t have a smear whilst pregnant or for 3 months afterwards as the cervix changes and the results are unreliable. When you’re 3 months post-natal, the cervix has settled down and you can book in. If you are due a smear whilst pregnant, it is perfectly safe to defer it until 3 months after having your baby.
Is there a ‘best’ time to have it?
They say that mid cycle is the best time to have a smear but it really doesn’t matter. If you’re bleeding then the cell sample is often inadequate so avoid your period.
I went to the GP with a female problem and he/she didn’t do a smear. Should they have done?
A smear is not a diagnostic test, just a screening test, so if you are being investigated for a problem it won’t be part of the tests a doctor or nurse does on you. If your symptoms are suggestive of cervical cancer you will be directly referred for a closer look with a colposcopy. You might find however that if you go for another problem that requires a speculum examination and you are due a smear, that the doctor will take the opportunity to get it done at the same time. If you have had a normal smear within the last 3 years, it is very unlikely that you could have a serious cervical problem.
What’s the science behind it?
The reason smear tests are useful is that it takes many years (between 10 and 20,) for cells to change from normal cells into a cancer cell, and they go through many stages on the way. If we can catch them before that, we can offer treatment to prevent the cancer.
Cervical cancer is caused by HPV16 and 18 (2 strains of Human Papilloma Virus or the common wart virus) and it is passed on through sex. This is not the same virus strain that causes genital warts. There are also some rarer forms of cervical cancer that are not related to HPV. Increasingly now smear tests also look for HPV – the virus often clears itself, but in some women it causes changes called CIN (Cervical Intraepithelial Neoplasia,) which can go on to turn into cervical cancer. HPV infection doesn’t guarantee you will develop pre-cancerous cells or cancer, but it makes the risk much more likely. You may have heard of or received the cervical cancer vaccine – it is actually against HPV.
I think that’s all for now and I suspect I am preaching to the converted. I hope many of you have had your first smear already but knowing how easy it is to forget, (I have done!) move house and not get the invitation, or just put it off, I thought it was worth reminding you all. Once again if there are any questions, just shout. Even if it’s something silly that you never wanted to ask your GP.
Disclaimer: This article was compiled using my knowledge and day to day practice. Although written by a qualified GP, this article does not substitute you attending your own GP and should not be used for individual medical advice. No liability can be accepted for decisions made on the strength of information contained here or elsewhere on Florence Finds.