Commonly known as a ‘smear test’ the process involves a small sample of cells being taken from the cervix looking for abnormalities. Evidence suggests many more lives would have been lost to cervical cancer if not for screening.
WHO SHOULD UNDERGO CERVICAL SCREENING?
The Department of Health in the UK recommends cervical screening for women between the ages of 25 and 64 years but screening can be performed at any time if there are overriding clinical considerations. Women aged 25 to 49 years should be screened for abnormal cervical cells every 3 years, while women aged 50 to 64 years should be screened every 5 years. HPV vaccination programs (see below) started in 2008; current advice is that vaccinated women should continue routine cervical screening.
HOW IS CERVICAL SCREENING PERFORMED?
The cervix is exposed and a special brush is used to obtain the cell sample. The test can only be performed when the woman is not on a period for best results. Although uncomfortable, the procedure should be relatively painless for the vast majority of women.
WHICH TESTS ARE DONE DURING CERVICAL SCREENING?
Cervical screening uses liquid-based cytology (LBC) to collect samples of cells from the cervix, which are examined under a microscope to look for any abnormal cervical cells. Cervical screening now also incorporates Human papillomavirus (HPV) testing. HPV is a common virus transmitted through sexual contact and there are over 100 subtypes. Thankfully, most do not cause significant disease and are easily eradicated by the immune system without need for treatment. Some subtypes of HPV (known as high risk HPV [HR-HPV]) can lead to abnormal cervical cells and if left untreated, may go on to develop into cervical cancer. Early detection and treatment of these HPV subtypes can prevent 75% of cervical cancers developing.
WHAT CAN WOMEN EXPECT FROM CERVICAL SCREENING?
Screening results showing borderline or low grade abnormal cell changes are interpreted based on HR-HPV test result. Women who are positive for HR-HPV require further diagnostic testing and treatment, while those negative for HR-HPV can return to routine screening.
WHAT FURTHER TESTS/TREATMENT MIGHT BE REQUIRED?
Women found to have moderate or high grade cervical cell changes and those positive for HR-HPV will be referred for colposcopy (microscopic examination of the cervix) and any further treatment required for the abnormality.
WHAT ARE THE RISKS OF CERVICAL SCREENING?
Cervical screening is a relatively safe procedure but the process is not perfect; there can be false positives and false negatives. The addition of HR-HPV testing has helped to reduce false positive results.