Cervical Cancer: What You Need To Know
Smear test. Cervical screen. Pap smear. Whatever you call it, make sure you get it. If you're due a smear but are feeling too anxious, too busy or plain didn't realise how important it is, this is your reminder to get that appointment in. You might have been put off by the lack of access to GP appointments, lockdown restrictions over the past two years or stories about how uncomfortable it is, but it really is so important to book your cervical screening appointment. Read on for advice, and our own personal experience with an abnormal smear result - it's more common than you think.
What is cervical cancer and how common is it?
Cervical cancer is a type of cancer that develops in the cervix (the entrance to the womb from the vagina).
Cervical cancer is the fourth most common cancer in women and those with a cervix. In 2018, an estimated 570,000 people were diagnosed with cervical cancer worldwide and about 311,000 died from the disease. Around 3,000 cases of cervical cancer are diagnosed in the UK each year. It's possible for people with a cervix of all ages to develop cervical cancer, but the condition mainly affects those who are sexually active, aged between 30 and 45.
The statistics are pretty sobering: cancer of the cervix takes two lives every day. What we do know is that smear tests save lives. In fact, 3/4 of those diagnosed with cancer could be prevented through regular cervical screening. This is a preventable disease - so it's vital we reduce stigma and encourage greater uptake of screening.
So, what can we do to reduce our risk?
First and foremost: Attend your cervical screening when invited.
About 3,100 cases of cervical cancer are diagnosed in the UK each year, with practically all of them being due to HPV. When you get a letter from your doctor inviting you to book your test, it's vital to make sure you follow up. The screening process aims to pick up early cell changes caused by HPV, known as the pre-cancerous stage, and to remove these cells before they become cancerous. Hence, screening can prevent cervical cancer from developing in the first place
Over to Team HANX's Emily:
"Last year, at the age of 31, I had my first ever cervical smear. Late to the party I know but for many of us, the narrative around smear tests is pretty daunting, with it presented as a horrible but necessary part of adult life. I remember my mum and her friends saying how awful it was and shuddering, which definitely made me less willing to go. Life got in the way and like many uncomfortable things, it was easier to put it on the 'to-do-one-day' list. Finally, the nagging feeling wouldn't go away, so I booked in with my local NHS practice - and I'm glad I did. No, it wasn't the most enjoyable 5 minutes of my life. Yes, it did hurt a little bit (but far less than I'd been expecting). Full disclosure: I fully recommend grabbing a hot chocolate to cheer yourself up afterwards. Most importantly though, I received a letter several weeks later informing me I needed a follow up appointment as I had cell changes, aka abnormal cells and HPV present. Now, not all abnormal cells require treatment or lead to cancer (our Co-Founder Dr Sarah Welsh demystified what your results might mean over in Glamour), but if they do, you'll be in the best of hands.
If you have a million other things to do, have no symptoms whatsoever, and always struggle getting a doctor’s appointment even in pre-pandemic times, you might also be putting off attending a cervical screening test. Remember, this screening programme saves lives, and the lack of symptoms means cervical cancer often goes undetected.
Equally, like me, you may have heard negative things about the cervical screening test and worry about what it involves. I highly recommend talking to your doctor or practise nurse about what to expect. They'll go through the procedure with you and put your mind at ease. The examination is over in seconds, can be uncomfortable but not painful and some people don’t feel anything at all.
I ended up having a coloposcopy and several regular check-ins, and finally got the all-clear for HPV. This means I now go back to having screenings at the usual three year mark. Even though I was scared at the start and intimidated by the hospital visits, the team was amazing and made sure I understood exactly what was going on at all times."
If you’re feeling anxious or have had a family/friend experience cervical cancer, it's often tempting to go for your cervical screening earlier than invited (they start aged 25 years in England). However, unless you are having any symptoms this is not helpful. Cervical screening in young people is more likely to pick up normal cell changes, which may result in unnecessary treatment while not changing the number of cases of cancer. Cervical cancer in those aged below 25 is very rare. Again, talk to your doctor about your worries and if there are any abnormal symptoms that suggest examination or further investigation is appropriate.
Know the symptoms of cervical cancer and seek medical advice if you experience any of them.
Symptoms can include:
- irregular menstrual bleeding
- bleeding between periods
- bleeding after sex
- increased vaginal discharge
- pain during sex
- bleeding after the menopause
These symptoms don't exclusively mean cervical cancer, and they are present in many different diseases, too. However, if you do experience any of the above, you should seek medical advice so they can complete a thorough history and examination. Knowing your normal is so important: if anything feels unusual or out-of-the-ordinary for your body, see a professional to get checked.
Having the HPV vaccination at age 11-18.
The human papillomavirus (HPV) is the name given to a very common group of viruses. There are many types of HPV, some of which are called "high risk" because they're linked to the development of cancers, including cervical cancer. Other types can cause conditions such as warts or verrucas. Nearly all cervical cancers are caused by infection with a high-risk type of HPV. HPV infections don't usually cause any symptoms, and most people won't know they're infected - which is why it's so important to get your cervical smear. In England, girls aged 12-13 years are routinely offered the first HPV vaccination, with the second dose 6-12 months after the first. The HPV vaccine is effective at stopping girls getting the types of HPV that cause most cervical cancers.
Talk to your friends and family.
A huge part of reducing yours and others’ risk of cervical cancer is by improving the education around it, and ensuring those people close to you are well informed. Talk to your friends and family, discuss cervical cancer, smear tests and educate each other. Challenge the negative narrative by focusing on the importance of the outcome. Intimate health can be a taboo topic to bring up even with your BFFs, but it's never been easier with the flurry of content demystifying the process. Here are a few ways to get the ball rolling:
- DM your group chat one of the Eve Appeal's reassuring IG Reels with Dr Sesay. It takes one second and cuts out any in-real-life awkwardness.
- Gift them a Lady Garden Foundation tote bag as a conversation starter: "This tote actually raises funds for gynaecological cancers! So, speaking of Lady Gardens... have you had a cervical screen lately?"
- Lean on celebrities' experiences of smear tests to open up the chat. Chrissy Teigen has posted on Instagram about the importance of getting a smear, whilst in the UK, Scarlett Moffat and Binky Felstead have spoken out about abnormal results, too. It makes a potentially scary topic more relatable if you can mention a big name who has openly discussed their experiences.
Know how to get a smear test if you're a trans man or non-binary person with a cervix.
Know where to find support and further information.
There is a wealth of support and information out there, including medical advice at your GP or hospital, as well as via your sexual health clinic.