Cervical Cancer and HPV screening: Have no fear, updates to the smear are here
Cervical Cancer Prevention week is the 23rd to the 29th January 2023 and aims to raise awareness of the risks of cervical cancer and help people to learn about how to reduce these risks and prevent the illness. The best way to prevent cervical cancer is through a cervical screening test (a ‘smear test’). There have been some updates to the testing process recently, below is everything you need to know about the changes.
What is cervical cancer?
Cervical cancer is a cancer found anywhere in the cervix, this is the opening between the vagina and the womb. Compared to other forms of cancer, it grows very slowly but it is still really important to diagnose it as soon as possible.
Nearly all cervical cancers are caused by an infection from certain types of human papillomavirus (HPV). HPV can be transferred through any skin-to-skin contact of the genital area. You may remember having an HPV vaccine at school, this helps protect against cervical cancer to some extent (reducing cervical cancer rates by almost 90% in women in their 20s!). However, it does not protect against all types of HPV that cause cervical cancer, so it is still important to have regular cervical screening tests.
Cervical cancer can affect women and people with a cervix of any age but it is most common in those who are 30-45 years old. It is rare for women under the age of 25 which is why in the UK, cervical screening tests are not offered until this age. Screenings stop when you reach the age of 64.
Some people are more likely to get cervical cancer, for example if you have a weakened immune system or if you have had certain cancers in the past.
The new cervical screening process – HPV primary screening
Smear tests are designed to check the health of your cervix and to identify any abnormal cells that have the potential to develop into cancer. Although they can be extremely uncomfortable and are not something people look forward to, they are a really important tool to prevent cervical cancer.
Whereas before the screening process would test your sample for cell changes, the updated process involves an initial test for HPV. This screening tests the cervical cells for the HPV virus first.
What if the HPV primary screening is positive?
If high risk HPV is found, the laboratory will then test your sample for cell changes. High risk HPV can cause cell changes in the cervix, which over time can develop into cancer. However, it is important to note that not all cell changes will develop into cancer, but it is of course very important to monitor any changes and give treatment if necessary.
If you test positive for HPV and the laboratory then identifies cell changes, you will be invited for a colposcopy to have a closer look at your cervix.
If you test positive for HPV but there are no cell changes, you will be invited back for cervical screening earlier than normal. Typically this is after 1 year.
What if the HPV primary screening is negative?
If the HPV primary screening result is negative, then your sample will not be tested for cell changes. Cell changes or cervical cancer are unlikely to develop without HPV, so you will be invited back to cervical screening in 3 or 5 years’ time, depending on your age and where you live.
How often should I have a smear test?
Smear tests are something people tend to forget about until they get the dreaded letter through the post asking them to attend. The tests are undertaken every 3 years for people between the ages of 25-49, but every 5 years if you are over the age of 49.
Now that HPV primary screening is undertaken, the UK National Screening Committee has advised the NHS that cervical screenings for people with a cervix aged 25 to 64 should be invited every 5 years (instead of every 3 years). This is because the primary screening is more accurate at detecting who is at a higher risk of cervical cancer, so the intervals for those who are not at high risk can be safely extended from 3 to 5 years.
This has been implemented in Scotland and Wales and is expected to be implemented in other parts of the UK soon.
There are charities you can contact for support and information relating to HPV, cervical screening, cell changes or cervical cancer. Jo’s Trust is a UK-wide charity dedicated to women affected by cervical cancer and abnormalities. They provide help both online and face-to-face and can be contacted 24 hours a day.
