Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
The NHS has screening programmes for several cancers. Until recently, though, only cervical cancer screening has actually been able to prevent cancer, because it picks up high risk changes so they can be treated and removed before they turn cancerous.
Virtually all cervical cancers are caused by infection with a virus called HPV. There are several kinds, but only a few are linked to cancer. HPV is so common that getting infected is more an occupational hazard than a sign you’ve been promiscuous.
Key times to be exposed are in your late teens or early 20s, but there’s another peak in women finding love second time around. Most women’s immune system fights off the infection within months, but
DON’T ASSUME YOU DON’T NEED A SMEAR IF YOU’RE NOT SEXUALLY ACTIVE. ANY WOMAN WHO’S EVER HAD A SEXUAL PARTNER COULD BE AT RISK
in some it stays and can lead to cancer many years later. That’s why since 2008, all 12 year old girls in the UK have been offered immunisation against several high risk strains. The evidence is that it’s most effective if it’s given at this age, before you’re sexually active. It’s not 100% effective, and it will be a few more years before the full benefits are seen. Most women are diagnosed in their 30s or early 40s, and it’s rare under 25. We still need a cervical smear programme, but hopefully the number of women with an abnormal smear (currently about 1 in 20) will start dropping dramatically. Every woman in the UK is invited for a cervical smear every 3 years from the age of 25-49, and every 5 years from 50-64. Over 65s don’t need to
be tested unless they haven’t been screened since they turned 50, or have recently had an abnormal result. The reason is, unlike most health conditions, which often get more common with age, risk of cervical cancer drops with age.
Cervical screening has been a huge success story in the UK. In the 30 years since the programme was introduced, 7% fewer women have been diagnosed with cervical cancer every year. But there’s no room for complacency. It’s no coincidence that the proportion of younger women under 50 taking up their screening invitation started rising just after BigBrother’s Jade Goody’s diagnosis in 2008, and stayed at about 74% until about 2012. But levels have been dropping since, and last year only 71.3% were screened. Over 50s are better about attending for screening, but rates have been dropping for a decade. Today 1 in 4 over 50s doesn’t get screened.
Cervical screening isn’t the whole answer. Most cervical cancers start slowly and can be picked up at screening, but some are aggressive and can develop between smears. Also, cervical smears aren’t 100% accurate, although recent changes to include high risk HPV screening have helped. So if you get bleeding between periods, after you make love, or after menopause, pain when you make love, or an unpleasant smelling discharge, you should get it checked. If you are diagnosed with cervical cancer, treatment depends on how far advanced it is – 8-9 in 10 women can be cured if it’s picked up before it spreads.
There’s new hope even in advanced cancer. A study with Nivolumab, which targets the immune system, showed that 1 in 4 women with advanced cancer responded to treatment. Early days, but exciting news. Next Week: How To Cut Your Risk Of Dementia
THERE ARE 2 SIMPLE STEPS TO PROTECT YOURSELF – HAVE YOUR SMEAR WHEN YOU’RE INVITED, AND ALWAYS GET WARNING SYMPTOMS CHECKED