It’s Cervical Cancer Prevention Week. Roughly nine women are diagnosed with cervical cancer every day in the UK, accounting for 2% of all new cancers in UK women. What many don’t realise is that almost every cervical cancer case is preventable.
Cervical cancer mortality rates have dropped by 21% over the last decade, and this trend is expected to continue.
What is cervical cancer?
Cervical cancer is cancer that affects a woman’s cervix, which is the entrance to the womb. The majority of cervical cancer cases are due to human papillomavirus, better known as HPV. Cervical cancer mainly affects sexually active women, aged between 30 and 49.
What are the symptoms of cervical cancer?
In the early stages of the disease, there are often no obvious symptoms so it can go undetected. However, if you notice abnormal vaginal bleeding happening during or after sex, if you’re bleeding in between periods abnormally or if you are bleeding through the menopause, speak to your doctor about this.
Don’t worry - abnormal bleeding does not automatically mean that you have cervical cancer. But this is something you should speak to a medical professional about to find out why it is happening.
Other symptoms of cervical cancer include vaginal discharge that can smell unpleasant, or if you’re experiencing discomfort and pain during sex.
From the age of 25, women will be invited to attend smear tests. These cervical screenings will check for abnormal cells that can develop into cervical cancer. Your doctor’s surgery will get in touch with you about your smear test, and these tend to continue until you’re 64.
How is cervical cancer treated?
Cervical cancer could be treated with surgery or it could be treated with radiotherapy. If the cancer is found early, a radical trachelectomy could be an option. In this procedure, the upper part of the vagina is removed along with the cervix and surrounding tissue but the body of the womb is kept.
A hysterectomy is another type of surgery that sees the cervix and womb removed. A course of radiotherapy may be needed too, to prevent the cancer from returning.
If the cervical cancer returns after what was thought to be a previous course of treatment, a major surgery may be the option. An after pelvic exenteration would see the cervix, vagina, womb, bladder, ovaries, fallopian tubes and rectum removed.
For more advanced cases of cervical cancer, a combination of chemotherapy and radiotherapy could be used to treat the illness.
Treatment can leave long-standing side effects like early menopause or infertility.
What can increase your risk of cervical cancer?
Smoking has a big effect on cervical cancer. Women who smoke are twice as likely to develop cervical cancer compared to women who do not. Because of the harmful effects of the toxins within the cigarettes, this directly affects the cells of the cervix.
Additionally, the use of immunosuppressant drugs can increase your chances of cervical cancer developing. These drugs will be available in tablet, injection, liquid or capsule form and will be prescribed by your doctor to treat a number of ailments.
These types of drugs are used to treat different conditions. This includes autoimmune diseases - as they attack your immune system, taking immunosuppressants will reduce this reaction. These illnesses include psoriasis, lupus and Crohn’s disease.
You may also be prescribed immunosuppressants if you’ve had an organ transplant.
What happens in a smear test?
When you attend your screening, a sample of cells will be taken from your cervix. In order to get these cells, a swab will be used inside of your vagina. A tool called a speculum will be used so the nurse can see inside when taking the swab. Whilst some women may find this uncomfortable, it is important to relax during the screening - it’s a routine check up and nurses see these parts all the time. The cells will be checked for abnormalities under a microscope, and your cells may be checked for HPV.
How long do smear test results take?
The results of your smear test should be with you within 14 days.
How often do you need a smear test?
The regularity of smear tests will depend on a number of factors. Depending on your age, your screenings will be more frequent - smear tests begin at 25 and tend to continue until 64. Between the ages of 25 and 49, you should be invited to screenings every three years. From 50 to 64, you’ll be expected to attend every five years.
You may need to attend more regular screenings if abnormal cells are present in your cervix.
Can you have a smear test while on your period?
It’s unlikely you’ll be able to proceed with your screening if you have your period. When booking your smear test, aim to go for the middle of your cycle. If you have your period, there may be blood in your sample which can make it hard to see the cells properly.
What is HPV?
Human papillomavirus (HPV) is the name of many common viruses - there are over 100 different types of HPV. Normally, these viruses do not cause problems but they are a known cause of cervical cancer as well as genital warts.
Previously, a vaccine was offered to school-aged girls (aged 12 to 13) but as of September 2019, all school children aged between 12 and 13 will be offered the vaccine. The second tends to be offered between 6 and 12 months later.
Even if you receive the HPV vaccine whilst you’re in school - or up until your 25th birthday - you should still attend your cervical screening. It is not guaranteed that the vaccine will protect you from all forms of HPV.
Many women will contract a form of HPV during their lifetime, but it can clear up on its own without any kind of treatment.
How is HPV spread?
Human papillomavirus can be spread through skin-to-skin contact of the genitals. It can also be spread through sharing sex toys or through oral, anal or vaginal sex.
How is HPV treated?
There is no treatment for HPV. However, if the HPV relates to cell changes in the cervix, treatment to remove these cells may be offered to avoid them becoming cancerous.
There are a number of options to remove these cells, such as LLETZ and cone biopsy.
LLETZ stands for large loop excision of the transformative zone and sees a wire loop that is heated with current to remove the abnormal cells. You’ll be awake for the procedure but you’ll be given local anaesthetic injected into your womb for the treatment.
A cone biopsy, on the other hand, is a procedure where a cone-shaped piece of tissue containing abnormal cells is cut out. This procedure is more likely to be used if there is a large area of tissue to deal with. You’ll be under general anaesthetic for this procedure and you may need to stay in hospital overnight while you recover.
For further information on cervical cancer, please visit the charity, Jo’s Cervical Cancer Trust.