Cervical Screening: Have No Fear, Get Your Smear!-image

Cervical Screening: Have No Fear, Get Your Smear!

Turning 25 not only marks the end of your first quarter of a century on earth, but it also calls for a (rather mundane) birthday card from the NHS, reminding you to book in for your cervical screening.  

Now you’re ‘of age’, this is going to become something of a routine for you every few years, but just because it’s routine, doesn’t mean we fully understand the ins and outs of pap smears – and if there really is anything to fear.  we’re taking you behind the screens and walking you through the who, what and why, of cervical screening. 

What even is your cervix?

We better start with the basics. The cervix is the lowest part of the uterus and is this area of tissue that connects it to the vagina, where it acts as the bouncer to the VIP cuterus club. Its cylinder-shaped narrow passage allows your uterine lining to shed, making its exit as your period – and it is also the checkpost sperm must make it through to reach its beloved egg. 

This narrow tunnel is also the last leg of the journey for a foetus on its way out to the wide womb-free world. At first glance, you might think “how on earth does a baby fit through that?!”, but fear not – your cervix dilates to allow the baby to pass through with more ease. 

What is cervical cancer?

Cervical cancer occurs when abnormal cells in the lining of the cervix start growing uncontrollably, eventually developing into a growth. A group of viruses called human papillomavirus (HPV) is the main cause of cervical cancer. 

Although it can affect people of all ages, it primarily affects those between the ages of 30 – 45 years, and affects as many as 3200 people a year in the UK.

HPV is a common virus and can be transmitted through sexual contact with an infected individual. More than 70% of unvaccinated people will get infected at some point in their life without knowing it as there are usually no symptoms.

There are many types of HPV, and they are often referred to as ‘low-risk’ or ‘high-risk’, based on whether they put a person at risk for cancer. A ‘low-risk’ type could cause warts, whereas a ‘high-risk’ type can cause cervical cancer, anal cancer, genital cancers, and cancers of the head and neck. Being infected with HPV doesn’t mean you’ll necessarily get cervical cancer, most HPV types are harmless and people will be able to recover from an infection naturally. 

In its earliest stages, cervical cancer does not have any noticeable changes, which can delay diagnosis.

Characteristic symptoms of cervical cancer include:

  • Bleeding between periods
  • Bleeding after penetrative sex
  • Bleeding that is unusually heavy
  • Bleeding after the menopause
  • Unpleasant smelling or blood stained discharge
  • Pelvic pain

Why should we undergo cervical screening?

The cervical screening programme aka ‘Pap Smear’ is designed to help detect abnormal changes in the cells of the cervix. It is designed to look out for pre-cancerous changes, which if left untreated, could develop into cervical cancer. 

The UK government also offers a HPV vaccination to all children at 12-13 years old. 

From the age of 25, every individual with a cervix is eligible for screening every three years until the age of 50, and then every five years until the age of 64, if your screening tests are normal. The frequency of your appointments may increase if any abnormalities are picked up, or if you have an increased risk of cervical cancer.

Irrespective of if you’ve had the HPV vaccine, you should consider attending your screening appointment. The current HPV vaccine available on the NHS immunises you against 4 of the HPV types, which cause more than 70% of cervical cancers. As the HPV vaccine does not protect against all types of HPV that can cause cervical cancer, it’s important to have regular cervical screening.

What can I expect during my cervical screening?

The whole procedure is relatively quick. The doctor or nurse will collect a small sample of cells from your cervix using a soft plastic brush. These cells will then be sent to the laboratory for analysis, to look for any abnormal changes in them, which could potentially lead to cervical cancer in the future.

The examination is a transvaginal exam, an instrument called the speculum will be used to widen your vagina to allow the brush to be inserted for the cervical examination. If you’re someone who is uncomfortable with vaginal penetration or vaginal examination, you may find an internal examination causing you some discomfort, and you should voice your concerns to your doctor beforehand.

So, don’t fear, get your smear !

Zoya Ali BSc, MSc

Zoya Ali BSc, MSc

Zoya is a scientific researcher with a Bachelor's degree in Biotechnology and a Masters in Prenatal Genetics & Foetal Medicine from University College London. Her research interests are reproductive genetics, fertility preservation, gynaecological health conditions and sexual health.

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