Cervical Screening Awareness

What is cervical screening?

This week is Cervical Screening Awareness week. It is vital that women between the ages of 25 and 64 be tested every 2/3 years. Cervical screening (or a smear test) is a way of checking the health of your cervix. During the test, a small sample of cells will be taken from your cervix using a swab stick. The cervix is the opening to your uterus from the vagina. This is not a test for cancer, it is a test to prevent cancer.

The sample is then checked for certain types of HPV (Human Papilloma Virus)  as some types of HPV can cause cervical cancer. Not all types of HPV are dangerous, but if your sample is positive for certain types of HPV, you will be called back for further tests.

The cervix

The cervix, also called the neck of the uterus, has many functions:
 
  • produces moisture to lubricate the vagina, which keeps the vagina healthy.
  • opens to let menstrual blood pass from the uterus into the vagina.
  • is able to produce mucus that helps sperm travel up the uterus and fallopian tubes to fertilize an egg previously released from the ovary.
  • holds the developing baby in the uterus during pregnancy by remaining closed, then widens to let the baby out through the vagina.

What is HPV?

Human Papilloma Virus is a family of viruses that we encounter many times in our life. There are different ways in which you can get HPV, including skin to skin contact, not just penetrative sex.
These include:
 
  • Vaginal, oral or anal sex
  • Any skin to skin contact of the genital area
  • Sharing sex toys

Some types of HPV are classified as “high risk” types, and are the ones that can cause cervical cancer. In most cases, even if you get infected with HPV your body will get rid of it without any problem. In some people however, it can stay in your body for a long time. The longer the virus stays in your body, the higher the risk of it penetrating the cervical cells and causing changes. These changes can lead to cervical cancer if not treated.

Types of cancer

The cervix is divided into the outer surface that opens into the vagina (ectocervix) and an inner surface that lines the cervical canal (endocervix). Two different cells types cover these two surfaces:

Squamous cells are flat, thin cells that cover the outer surface of the cervix (ectocervix).

Glandular cells are column-shaped cells covering the inner surface of the cervix (cervical canal or endocervix).

The Transformation zone is the area where the squamous cells and glandular cells meet. This is where most cervical cancers start.

There are two main types of cervical cancer. They take the name after the cells they start in:

Squamous cell carcinoma (SCC) – this is the most common type of cancer, it starts in the squamous cells of the cervix. It accounts for about 7 out of 10 cases (70%).

Adenocarcinoma– This is a less common type (about 25% of cases), starts in the glandular cells of the cervix. Adenocarcinoma is more difficult to diagnose because it occurs higher up in the cervix, therefore the abnormal glandular cells are harder to find. 

There are a small number of cervical cancers that feature both squamous cells and glandular cells. Those are known as adeno-squamous carcinomas or mixed carcinomas.

Cervical cancer and the menopause

Depending on the spread and severity of the cancer, some treatments may cause the onset of menopause. This is because, depending on the stage of cancer it could spread towards the ovaries and uterus. If this is the case, your consultant is likely to recommend the removal of your ovaries and uterus – causing your body to enter menopause straight away. Other alternative treatments such as radiation or chemotherapy can cause your ovaries to stop working, leading to a decrease in the production of oestrogen which will also have the effect of inducing menopause.

Cervical cancer is often curable if caught early which is why it is so important to have regular tests to diagnose and treat cancer as early as possible before it spreads.

If you are aged between 25 and 64 and have not had a test in the last 2-3 years, contact your GP or sexual health provider to arrange a smear.