Cervical Cancer Prevention: Smear Tests & HPV Vaccinations Explained

January 18, 2021

Let’s face it, over the past few years, we’ve all been challenged to adapt and reassess our priorities. However, one thing that hasn’t changed is the importance of attending a cervical screening.

According to Cancer Research UK, around 3,200 women are diagnosed with cervical cancer in the UK each year. That’s nearly 9 cases diagnosed every day [1]. Cervical cancer can affect anyone with a cervix at any age but is most common in women under the age of 45 [2].

The good news? 99.8% of cervical cancer cases are preventable [3]. For this reason, knowing the symptoms and taking the steps to attend a smear test are vital.

Cervical Cancer Prevention Week

The 22^nd – 28^th of January 2024 marks the seventh annual Cancer Prevention Week. This year, it’s more important than ever to help raise awareness of the condition and how to prevent it.

What is cervical cancer?

The cervix is the lower part of the womb (also called the uterus). Known as the neck of the womb, it is the opening to the vagina from the womb – see the diagram below to show its position in the body. Cervical cancer is when abnormal cells in the lining of the cervix grow in an uncontrolled way and eventually form a growth (called a tumour) [4].

What causes cervical cancer?

Most cervical cancers are caused by a sexually transmitted infection called Human Papillomavirus (HPV). Approximately 80% of people will experience HPV at some time in their life, but it usually clears up on its own without the need for any treatment. However, if the body is unable to clear the virus, there is a risk of abnormal cells developing, which could become cancerous. HPV is usually spread through skin-to-skin sexual contact, meaning that it does not require penetrative sex to be transmitted [5]. It can be transmitted through oral, vaginal, or anal sex, as well as through using sex toys. Practicing safe sex with a condom can help to reduce your risk of developing the infection.

What are the symptoms?

According to Cervical Cancer Charity Jo’s Trust [6], common symptoms include;

Vaginal Bleeding that is unusual for you – i.e. bleeding between periods, after the menopause, or after sex
Pain or discomfort during sex
Vaginal Discharge – change to or unpleasant-smelling smelling vaginal discharge
Unexplained pain in your lower back or pelvis

If you do experience these symptoms, it doesn’t mean that you definitely have cervical cancer, but the NHS recommends that you see your GP as soon as possible to check them out [7].

Cervical cancer prevention

HPV vaccination

In the UK, the NHS offers a free vaccine which protects against the types of HPV responsible for most cervical cancers. The vaccine is recommended for children aged 12 to 13 years old and people at higher risk from HPV [8]. The vaccine is designed to reduce the risk of cervical cancer significantly; since its introduction, there has been a big drop in the number of young people getting conditions linked to HPV, including cervical cancer and genital warts [9]. However, even if you have had the vaccine, it is still important to attend your cervical screening. The vaccine does not guarantee immunity from the condition.

Cervical screening (Smear Test)

One of the best ways to prevent cervical cancer from developing or progressing is by attending a cervical screening. A cervical screening (also called a Smear Test) is an examination by a nurse or doctor to look for abnormal cells that could potentially turn into cancer. The test itself doesn’t test for cervical cancer but can identify abnormal changes to cervix cells at an early stage. From age 25, women are invited for a screening every three years (from ages 50-64 this changes to every 5 years). In the UK, you will receive a letter from your GP with a date for your test.

Attending a cervical screening isn’t something that most people look forward to, but attending your test is important as the potential benefits far outweigh any minor embarrassment. Gynaecological cancer charity The Eve Appeal, states that the screening programme is estimated to save over 4,000 lives each year [10].

What happens during your smear test?

You will meet your nurse or doctor, sometimes called a sample taker, who will invite you into a treatment room. They will then explain what cervical screening is and check if you have any questions. You will then be given a private space behind a curtain to undress from the waist down, covering yourself with a new, clean paper sheet to cover the lower half of your body. If you are wearing a dress or skirt, you can leave this on and just take off your underwear.

Once ready, your nurse will ask you to position yourself with your hands under your pelvis to raise your hips and then spread your knees. The nurse will then apply a small amount of lubricant and insert a speculum (a plastic cylinder with a round end – sometimes a metal speculum is used) into the vagina to be able to see the cervix. The nurse will then use a small soft brush to extract the cells. This may feel a bit strange, but it should not be painful. Some people find it a little uncomfortable when the speculum is inserted, but this is over very quickly.

Top Tips: You can bring someone with you - A friend, family member, partner or someone else. They can be in the waiting room or examination room with you to offer support.

Did you know that speculums come in different sizes? You can ask for a smaller size speculum during your examination if you wish.

Important: You’re in control of the cervical screen test and can ask the nurse to stop anytime.

How long does it last?

The appointment is usually around 20 minutes, the procedure itself is over quickly, lasting 3 minutes.

When can I expect my results?

After the cells are extracted and sent off for testing, your results will be returned in around 2 to 6 weeks.

Can I take my own lubricant with me?

Some people like to take their own lubricant to a screening. However, it is worth noting that more research needs to be conducted to rule out a lubricant affecting the test results, so do speak to your nurse or GP about this first. It’s recommended that you avoid using a spermicide or oil-based lubricant 24 hours before the test as these can affect the result [11].

For women experiencing dryness or atrophy, some nurses recommend the use of a vaginal moisturiser or vaginal oestrogen for 14 days before the test but make sure you stop this treatment 24 hours before the test [12].

I’m Menopausal – does this change anything?

If you are menopausal or postmenopausal, you should continue to have smear tests. However, after menopause, the opening of the vagina and vaginal walls become less able to stretch, which can lead to vaginal dryness, which can make the test more uncomfortable. If this is the case, you can ask your nurse to prescribe you a vaginal oestrogen cream or pessary, which may help.

You can also try using a vaginal moisturiser before your appointment. A moisturiser is different to a lubricant – it can be applied regularly, as and when needed, and lasts longer than a lubricant. YES® VM, our pH-matched vaginal moisturiser, can provide relief from the symptoms of vaginal dryness in less than an hour, with relief lasting for up to 3 days. Experiencing vaginal dryness? Explore our guide to understanding and treating vaginal dryness here.

Cervical Cancer Resources

Looking for more information on Cervical Cancer? See the following resources:

The Eve Appeal Website
The Eve Appeal Gynaecological Cancer Leaflet
Jo’s Trust Website
Cancer Research UK Website
NHS Website

You can also call Jo’s Cervical Cancer Trust Helpline for free information, advice or support: 0808 802 8000.

References:

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