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