Dr Sarah Jarvis

My Weekly’s favourite GP from TV and ra­dio writes for you

My Weekly - - Contents - DR SARAHJARVIS

Lots of pa­tients tell me that get­ting old is not for the faint-hearted. I usu­ally re­spond that I’d rather be any age than a teenager.

They have a point – I spend much of my time ex­plain­ing to pa­tients that their lat­est con­di­tion gets more com­mon with age. But cer­vi­cal can­cer is slightly dif­fer­ent, and the good news is that there does come a time when the risk drops.

Make no mis­take – cer­vi­cal can­cer is a killer. But in many other re­spects it’s dif­fer­ent to other can­cers. Firstly, it’s al­most in­vari­ably caused by the Hu­man Pa­pil­loma Virus, or HPV. There are many strains and only a few lead to can­cer; oth­ers cause gen­i­tal warts. Pretty much any woman who’s ever had sex, even if only with her hus­band, is at risk of HPV. Most women’s im­mune sys­tems fight off the virus. But in some, it lies in wait in the body. Years later it can cause ab­nor­mal­i­ties in cells of the cervix which even­tu­ally turn to can­cer. The only way of know­ing if you’ve got rid of it nat­u­rally is to have a smear. That’s the bad news – one of the other main dif­fer­ences is good news. Be­fore “full blown” cer­vi­cal can­cer de­vel­ops, the cells on the sur­face of the cervix go through early, pre­can­cer­ous changes. These range from low to high grade and can be picked up with a smear. It usu­ally takes years for in­va­sive can­cer to de­velop – so early changes found on a smear can al­most al­ways be treated and re­moved be­fore they ever do se­ri­ous harm. Ba­si­cally, hav­ing reg­u­lar cer­vi­cal smears can ac­tu­ally stop you get­ting can­cer.

EVEN IF YOU’RE NO LONGER SEX­U­ALLY AC­TIVE, YOU NEED TO HAVE SMEARS UN­TIL YOU’RE 64 IF YOU’VE EVER HAD IN­TI­MATE RE­LA­TIONS

Cer­vi­cal can­cer is of­ten thought of as a young woman’s dis­ease. Just over 1 in 40 women in their late 20s have a high grade ab­nor­mal re­sult, com­pared to un­der 1 in 200 in women aged 50-64.

So across the UK, women are in­vited for a smear test ev­ery 3 years be­tween the ages of 25-49. Some early changes aren’t can­cer­ous or even pre­can­cer­ous, but they need keep­ing an eye on.

If you have a mildly ab­nor­mal re­sult, you’ll be in­vited back sooner to see if the changes have gone. If the cells are more ab­nor­mal, you’ll be in­vited for a col­poscopy to ex­am­ine your cervix in more de­tail.

While it is more com­mon in younger women, the risk doesn’t dis­ap­pear when you reach 50. How­ever, can­cers which do de­velop tend to do so more slowly, so women are only in­vited for a smear ev­ery 5 years from the age of 50.

If you’ve had nor­mal smears to the age of 64, your risk is tiny. You needn’t worry about smears from then on.

As in many health ar­eas, ma­ture women lead the way in pro­tect­ing them­selves against cer­vi­cal can­cer. Lat­est fig­ures show a much higher pro­por­tion of 50-64-year-olds are tak­ing up their screen­ing in­vi­ta­tions com­pared to 25-49-year-olds.

Wor­ry­ingly, al­most 1 in 3 women in the younger group are not up to date with their cer­vi­cal smear. But even among older women, fig­ures are fall­ing. Last year, 77% women aged 50-64 had a smear com­pared with 78% the year be­fore and more than 80% in 2011.

Vagi­nal dry­ness can make smears (and sex) more un­com­fort­able, but your doc­tor will be happy to pre­scribe top­i­cal cream for a few weeks be­fore the smear test to min­imise dis­com­fort.

Re­mem­ber it’s a small price to pay for peace of mind! Next week: Is it risky to mix herbal sup­ple­ments and pre­scrip­tion meds?

THE AIM OF SMEARS IS TO PICK UP AND TREAT CHANGES BE­FORE THEY BE­COME CAN­CER­OUS. THEY CAN AC­TU­ALLY PRE­VENT CAN­CER!

HAV­ING REG­U­LAR CER­VI­CAL SMEARS CAN AC­TU­ALLY STOP YOU GET­TING CAN­CER’’

Older women are lead­ing the way

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