A smear test can save your life

The Southland Times - - WELL & GOOD - CATHY STEPHEN­SON

New Zealand has a wellestab­lished cer­vi­cal screen­ing pro­gramme, avail­able to all women from 20 to 70 years of age. We know with­out doubt that this type of screen­ing saves lives – yet we still lose 60 women ev­ery year to cer­vi­cal cancer. We also know that women in our Ma¯ori, Pasi­fika and Asian pop­u­la­tions at­tend far less of­ten for smear tests, and are more likely to de­velop cancer as a re­sult.

So if you are un­sure about book­ing your smear test, or know some­one who has never been for one but re­ally should, here’s what it en­tails, and why it’s so im­por­tant:

Cer­vi­cal cancer is caused by ex­po­sure to HPV (hu­man papil­loma virus) through sex­ual con­tact. Most of us who have ever been sex­u­ally ac­tive will have been ex­posed to this virus at some point in our lives – but very few of us will ever know about it at the time.

There are many strains of this virus – some cause gen­i­tal warts, but some lead to cancer of the cervix, throat, anus and pe­nis. It is not pos­si­ble to de­velop cer­vi­cal cancer with­out ex­po­sure to HPV.

The rel­a­tively new, safe and in­cred­i­bly im­por­tant Gar­dasil vac­cine pro­tects against nine strains of HPV, in­clud­ing those most likely to cause cer­vi­cal cancer. The ear­lier you are vac­ci­nated (ideally be­fore you start hav­ing sex) the more pro­tec­tion you will get, and the lower your risk of de­vel­op­ing cer­vi­cal cancer later on. Gar­dasil is now free for boys, girls, men and women, up to 26 years of age, and peo­ple out­side of this age range can choose to pay for it if they would like to be vac­ci­nated.

The cer­vi­cal screen­ing pro­gramme aims to pick up changes in the cervix long be­fore they de­velop into cancer. In these early stages (known as CIN 1, 2 and 3) these types of ‘‘pre-cancer’’ are easy to treat – if left un­de­tected, they may de­velop into full cer­vi­cal cancer. Not easy to treat.

In all coun­tries around the world which have es­tab­lished cer­vi­cal screen­ing pro­grammes, the women who die from cer­vi­cal cancer are the ones who have ei­ther never been screened, or have only been screened in­fre­quently.

Our screen­ing pro­gramme here rec­om­mends three-yearly check ups for ev­ery­one from 20-70 years of age. How­ever, from next year the start age will go to 25 as we know that women younger than this are at much lower risk of cancer, and are more likely to have pro­tec­tion from the Gar­dasil vac­cine.

All peo­ple who have ever had sex and were born with fe­male gen­i­talia (so this in­cludes trans males) should get reg­u­lar smear tests, even if they fall into the fol­low­ing groups: Sin­gle women Women in same sex re­la­tion­ships Women who are no longer hav­ing sex

Women who have had the full course of Gar­dasil vac­ci­na­tions

Women who have been through the menopause. It’s re­ally im­por­tant you feel com­fort­able with where you are going for your cer­vi­cal smear, and who is going to be do­ing the test. All GP clin­ics of­fer this, and in many of them you can choose to have ei­ther your doc­tor or the prac­tice nurse take your smear.

If you would rather go some­where else that’s fine too. Fam­ily Plan­ning, sex­ual health clin­ics, marae-based or other Ma¯ori health cen­tres, and com­mu­nity health ser­vices such as Pa­cific or women’s cen­tres, all of­fer cer­vi­cal screen­ing. You can find out where to go, and ask about a fe­male smear-taker if that feels eas­ier for you, by call­ing the screen­ing pro­grammes free num­ber 0800 729 729.

If you’ve never been for a smear be­fore, I’d rec­om­mend you ei­ther talk to a friend or whanau mem­ber who has, or read the in­for­ma­tion on the web­site time­to­screen.nz – it talks you through what is in­volved, and what you should ex­pect.

Hav­ing been for reg­u­lar screen­ing my­self, but also hav­ing done thou­sands of smear tests over the years, I can as­sure you – if done well, with plenty of ex­pla­na­tion and re­as­sur­ance, it shouldn’t be a painful or­deal. It is su­per quick, as the test it­self only takes about two min­utes, and you can have who­ever you like with you to sup­port you if needed.

Many women I know find it very dif­fi­cult to share this part of their bod­ies with a health pro­fes­sional, but as a doc­tor this is such a large, and im­por­tant part of the work I do, I try to en­sure that ev­ery­one feels OK about it – my philosophy is that if the first smear is done care­fully, pain­lessly and thought­fully, com­ing for the sec­ond one is a much eas­ier process! So go on – pick up the phone and book yours! Dr Cathy Stephen­son is a GP and foren­sic med­i­cal ex­am­iner.

123RF

It’s im­por­tant you feel com­fort­able with where you are going for your cer­vi­cal smear, and who is going to be do­ing the test.

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