Smear tests so vital in preventing killer cancers

Cervical Cancer is a killer – but it can easily be prevented with regular smear tests. Advanced nurse practitioner Lorraine Cooper, from the Derby Open Access Centre, talks about why it is so important to raise awareness of the disease.

WE have decorated the waiting rooms in pink, put up information boards, sent out reminder letters to our patients and colleagues – and I will be wearing all pink.

This is because Cervical Cancer Prevention Week 2013 is taking place until Saturday.

It is a European-wide initiative, led by the European Cervical Cancer Association, to raise awareness of the symptoms and causes of cervical cancer, with the aim of increasing the uptake of the human papilloma virus (HPV) vaccine and smear tests.

We are working with Jo's Cervical Cancer Trust, the UK's only charity dedicated to women and their families affected by cervical cancer and cervical abnormalities, in supporting Cervical Cancer Prevention Week.

Cervical screening began in Britain in the 1960s and, by the 1980s, although many women were having smear tests, there were concerns that those women at risk were not being tested, and those with positive results were not being followed up and treated effectively.

In 1988, the Department of Health set up the NHS Cervical Screening programme for all women aged between 25 and 65 years. It ensures that more than three million women in England are screened every year.

In Derby, the programme has a call and recall system in place so that, when a woman reaches the age of 24 years and six months, they will automatically receive an invitation to attend their surgery for cervical screening.

As an Advanced Nurse Practitioner (ANP), my role includes conducting all the smear tests for our patients at Derby Open Access Centre.

I think it is vital to raise awareness of cervical cancer, especially when you consider that, in 2010, only 50% of girls aged between 12 and 18 offered the HPV vaccine in the catch-up programme elected to do so and, last year, 20% of women in the UK did not take up their invitation for cervical screening.

Every year, more than 3,000 women in the UK are diagnosed with cervical cancer.

It is not thought to be hereditary and, in 99.7% of cases, it is caused by persistent infection of the human papilloma virus (HPV).

This is a very common virus, transmitted through skin-to-skin contact in the genital area, and around four out of five women will have contracted it at some point in their life.

For many women, this infection poses no threat but, for others, it can lead to cervical cancer.

Regular cervical screening (or smear tests), which allows detection of any early changes of the cervix and, for younger women, the HPV vaccination, can help protect 70% of women against the HPV virus which can lead to cervical cancer.

Cervical screening is not a test for cancer but is a method used to help detect any abnormality or changes in the cells on the cervix that, if left untreated, could lead to cancer at a later date.

There are usually no symptoms with abnormal cells (in their pre-cancerous state) and can often be no symptoms with early-stage cervical cancer.

However, there are some recognised symptoms associated with the disease. These include:

Abnormal bleeding after or during sexual intercourse or between periods.

Post-menopausal bleeding, if you are not on HRT or have stopped it for six weeks.

Unusual and/or unpleasant vaginal discharge.

Discomfort or pain during sex.

Lower back pain.

If you are experiencing any or all of these symptoms or you are concerned, you should make an appointment to see your GP as soon as possible.

Remember, these symptoms can be associated with many other conditions that are not cancer-related.

Not all women who have been diagnosed with cervical cancer experienced symptoms. Therefore, attending regular cervical screening is even more important.

I think some women put off coming in for their smear tests because they are embarrassed or concerned that it will be painful.

While some women may say that it is mildly uncomfortable, it is by no means a painful procedure and the appointment is generally with either the doctor or the nurse at your surgery, or you can attend a sexual health or community clinic.

You can also request to see a female doctor or nurse if it would make you more comfortable.

When you attend for a cervical smear, you will be asked to lie on a couch and a sample of cells will be taken from the cervix before being sent to the laboratory for analysis.

The procedure lasts no more than 10 minutes and the results are aimed to be back within 14 days.

Here in Derby, you will be asked for your contact number when the nurse or doctor is completing the relevant forms, the reason being that, if an abnormality is detected, you will be contacted by the laboratory directly and an appointment made for you to attend a clinic at the hospital for further investigations.

This in turn will help to detect an early diagnosis of any cell changes that may be occurring and the appropriate treatment or management can commence.

At the Derby Open Access Centre, we contact all women eligible for cervical screening by phone, as well as sending letters in various languages to help them make their own choices about attending for a smear test.

We provide a respectful and confidential service to all our patients attending for cervical screening and we run education sessions in the community, offering information that is written in various languages to explain the procedure.

If caught early, survival rates for cervical cancer are high. So please, spread the word to your friends and family and be symptom-aware. The chances are it will not be cervical cancer but it is always better to get it checked.