Dr C: “It’s so important to have your smear”
Celebrities have been urging women not to delay their cervical screening after attendance dropped dramatically due to the pandemic. Dr C explains why they’re right
Celebrities like Love Island’s Laura Anderson, TOWIE’s Jess Wright and Strictly’s Karen Hauer are asking women to go for their smear tests because we have seen a big drop in attendance – particularly during the pandemic. Jo’s Cervical Cancer Trust charity say 600,000 fewer tests than normal were carried out last April and May due to Coronavirus, and that’s on top of the 1.5 million appointments missed each year.
CRUCIAL MESSAGE
Radio DJ Maya Jama recently told her online followers to go for their smear tests, having delayed hers for a year and finding out she had abnormal cells. Meanwhile, model Chrissy Teigen shared a photo of her attending her cervical screening mid-pandemic, and TV presenter Scarlett Moffatt hosted a Q&A about smears on Instagram, having being told she had abnormal cells. Twelve years on from Jade Goody’s death, it’s crucial to keep getting this message out.
SAFETY FIRST
In a year where nearly one in three women didn’t attend their cervical screening, it’s important women know they are taking place again, with clinicians wearing PPE and patients wearing face masks to keep everyone safe from COVID. Women are invited to a screening every three years between the ages of 25 and 49, because that’s when the risk is highest, and then every five years until the age of 65. Women who had the HPV vaccine as teens when it first became available in 2006 are being called up for their cervical screenings, too. It is routinely offered to girls and boys aged 12 and 13 via the NHS. The vaccine is good, but it’s just for the highest risk HPV strains and not everybody responds to vaccines in the same way. A study found an 89 per cent drop in severe cervical abnormalities, but nothing is totally watertight so, if you get an invite, attend.
AT-HOME OPTION
The NHS is launching a new trial, where more than 30,000 women will use at-home swabs to check for HPV, the virus that causes cervical cancer.
They will go to women aged
25 to 64 who are 15 months overdue for a check and live in areas where attendance is low. Embarrassment is a key reason for women not attending, so if this is a success, it could be rolled out nationally, and everyone would have the option of an at-home swab. If it came back negative they wouldn’t need a cervical smear for another three years. If it came back positive, they would need a follow-up screening with their GP.
TAKING OWNERSHIP
You can also already buy these kits for around £48 from Superdrug, but people may be wondering how they could replicate what a nurse does during a cervical screening. This isn’t the same – it’s a HPV test, looking for presence of that virus, rather than for changes in cells in your cervix. You gently insert a swab, like a long cotton bud, into your vagina, rotate it for 20 seconds, remove it, then send it off. In sexual health screenings, women already do exactly this. It works just as well. Women feel incredibly vulnerable when they’re being examined, so to be able to do it yourself in your own home is really important.
OVERCOMING FEAR
The at-home swab tests for HPV, because it’s the cause of cervical cancer in virtually all cases. If your test is positive, you’ll be called by your doctor for the usual cervical screening, or
smear test, because the at-home swab can’t take cells from your cervix, it can only check for virus from the walls of your vagina. You would then have the standard test and the cells would be looked at under a microscope so we know if any changes are worrying or harmless. If you have abnormal cells, which is the case for one in 20 screenings, you may be asked to have another screening in six months (like
Scarlett Moffatt), because your body usually clears it naturally, or you may be invited for a colposcopy, where we look close up with a big microscope. We can sometimes remove the cells there and then, or we may not need to do anything. It’s all quite gentle, which is important, as lots of women are scared when they hear they have abnormal cells. Cervical cancer is very slow to develop, so even if we find abnormal cells, the vast majority of cases won’t develop into cancer.
MAKING IT COMFORTABLE
Most women will still go to their GP for a cervical smear for now, and there are ways to make it more comfortable. The more relaxed you are, the better, because muscular tension in your pelvic area makes it hard to insert the speculum. If you are nervous, explain that before you start, because it’s the doctor or nurse’s job to put you at ease. If you get halfway and can’t carry on for whatever reason, ask them to stop and come back. Choose who does it, so if you have a male doctor and you would like a female nurse, ask for them. If you start getting tense, ask to pause so that you take some breaths. Put the soles of your feet together so that your knees drop down to the sides, that will get you in a much better position than lying flat with your knees up. Wear a skirt or dress if you want to feel covered and if there’s any hint of the person being annoyed or unsympathetic, ask to see someone else. Also alert the surgery if you have a bad experience, as it could put someone off having screenings.
EASILY TREATED
About a third of the population have a type of HPV, but certain strains cause changes to cervical cells that can lead to cancer. It’s easily treated, managed and cured, but only if we know it’s there, so please come forward.