Dont Fear The Smear

Cervical cancer is highly treatable if it is caught early. The best way to know about changes in your cervix is to go for a regular smear test. It’s free, painless and takes less than five minutes.

 

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Smear tests take a sample of cells from neck of womb

 

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Regular smear tests are free

 

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Pick any of the +4,500 registered GPs or nurses

 

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Takes less than five minutes

 

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Most test results are normal

 

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Check when your next smear test is due at CervicalCheck.ie

Feel the fear and do it anyway!

Check if you are on the register- CervicalCheck.ie 

CervicalCheck sends invitations by letter to women on the register who have never had a free CervicalCheck smear test. You can check if you are registered if you do not receive a letter of invitation. You can register yourself online or you will be automatically registered when you  attend for your first CervicalCheck smear

Women aged 25 to 60 years of age who have never had a CervicalCheck smear test can simply make an appointment with a registered GP practice or clinic, even if you have not received a letter of invitation.

If you are on the register, you can check when you are due for your next free cervical smear test here.

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Make time for a test!

What is cervical cancer?

Cervical cancer is cancer that starts in the neck of the womb which is called the cervix. The womb and cervix are part of a woman's reproductive system, which is made up of the

  • Vagina
  • Womb, including the cervix
  • Ovaries

The cervix is covered with a layer of skin-like cells on its outer surface. These cells can become cancerous, leading to cervical cancer.

In Ireland, about 300 women are diagnosed with cervical cancer each year. It is the second most common female cancer in Europe.

Early treatment can prevent changes in the cervix developing into cancer.

Symptoms of Cervical Cancer

  • Abnormal vaginal bleeding between periods, after sex or after menopause, unusual and/or unpleasant vaginal discharge
  • Discomfort or pain in your pelvis
  • Discomfort, pain or bleeding during or after sex
  • Lower back pain
  • Go to GP if you have any symptoms or are worried
  • Pre-cancerous cells and early cervical cancer may not have any symptoms which is why going for regular smear tests is so important

How Irish women spend some of their time

 

Lipstick

Irish women spend an average of 3,285 minutes a year doing our makeup

hair-dryer

We spend 3,513 minutes a year doing our hair

razor

We spend 577 minutes a year shaving or waxing our legs

A smear test takes sample of cells from neck of womb

A nurse or doctor takes a sample of cells from the cervix with a small brush. They send the sample to a laboratory to be checked for abnormalities. In some cases, samples are also tested for a virus called human papilloma virus (HPV) that increases the risk of cervical cancer.

It’s free

CervicalCheck is part of the National Screening Service. A cervical smear test is totally free for women between the ages of 25 and 60.

Pick any of the 4,500 registered GPs or nurses 

You don’t have to go to your usual GP for your smear test if you don’t want to. Sometimes women prefer to find a female GP or nurse to do their smear test or find it more comfortable to go to a health care professional that they don’t know. Others prefer to go to the GP or nurse that has always looked after their health. Either way, the choice is yours. Check the CervicalCheck website to find all the participating practices in your local area.

The test takes less than five minutes

Having a smear test is relatively quick and simple- it should take less than five minutes. Most women do not experience any pain. You will be asked to undress from the waist down and lie on your back. The doctor or nurse will gently insert a disposable device called a speculum into your vagina in order to see the cervix so as to obtain a good sample and check that  your cervix looks healthy. The doctor or nurse will then use a small brush to gently remove a sample of cells from the cervix. The sample is sent to the laboratory to be checked for any changes or irregularities.

Most smear test results are normal

About 9 in 10 routine smear test results are normal. You will receive your results in a letter within 4 weeks of your smear test. If your results are normal, CervicalCheck will send you another letter in 3-5 years, depending on your age, to invite you for your next smear test. If you are aged between 25-44 you should have a smear test every three years. If you are aged between 45-60 you should have a smear test every five years unless you are otherwise informed. Please do go for your regular smear test as cells can change over time and it is through regular smear tests that you can help yourself to stay healthy.  It is important to emphasise that most changes are pre-cancerous and the smear test is not to detect cancer but detects changes before a cancer develops. If you do develop any of the symptoms listed below or have any concerns, contact your GP without delay.

Results that are not normal

Please try not to worry if you are called back for another test. Changes are common and cervical smear tests can pick up early cell changes so they can be monitored or treated. The earlier abnormal cell changes are found, the easier they are to treat.

  • Inadequate sample

Some results are due to problems with the smear test rather than because there are any abnormal cells. You may be told that you need a repeat smear test because it could not be read properly. This is sometimes called having an inadequate sample. This could be because:

  • There were not enough cells in the sample
  • You had an infection and it wasn't possible to see the cells clearly enough
  • You were having a period and there was too much blood to see the cells clearly
  • The cervix was inflamed and it wasn't possible to see the cells clearly enough
  • Having sexual intercourse, the use of lubricants the night before a smear can affect the result

In all these cases, the letter you get will ask you to go back and have another smear test. This is usually about 3 months later.

Low grade changes

If your abnormal smear test result is due to changes in the cells of the cervix, the changes can be low grade or high grade.

Low grade changes are common and most clear up on their own. When these changes are found, your smear test sample will be tested for certain types of HPV infection.

High grade changes and colposcopies 

If the changes in the cells of your cervix are high grade, these are less likely to clear up on their own and you will need to have a more detailed exam called a colposcopy. A colposcopy is a detailed examination of the cervix that is carried out in a hospital out-patient clinic. The doctor or nurse in the clinic will look at your cervix using a type of microscope called a colposcope. This does not go inside you. A visit to a CervicalCheck colposcopy clinic is free of charge and the doctor or nurse who took your smear test will arrange it for you.

Check your are on the CervicalCheck register

CervicalCheck sends invitations by letter to women on the register who have never had a free CervicalCheck smear test. You can check if you are registered  if you do not receive a letter of invitation. You can register yourself online or you will be automatically registered when you attend for your first CervicalCheck smear

Women aged 25 to 60 years of age who have never had a CervicalCheck smear test can simply make an appointment with a registered GP practice or clinic , even if you have not received a letter of invitation.

If you are on the register, you can check when you are due for your next free cervical smear test here.

Have a regular smear test every 3-5 years

Don't Smoke

Practice safe sex

Make sure your daughter gets the HPV vaccine

Have regular cervical smear tests, every 3-5 years

  • Women aged 25 to 60 who have never been sexually active should have regular smear tests and continue to have regular smear tests after the menopause.
  • Women aged 25 to 44 years will receive a letter inviting you to go for a free smear test every three years
  • Women aged 45 to 60 years will receive a letter inviting you to go for a free smear test every five years.

Don’t smoke

If you smoke, you are more likely to develop cervical cancer. Researchers have found cancer causing chemicals (benzyrene) from cigarette smoke in the cervical mucus of women who smoke. Scientists think that these chemicals damage the cervix. Research also shows that the cells that line the cervix which specifically help fight cervical cancer (Langerhans cells) do not work so well in smokers.

If you have a high risk type of HPV infection (see section on HPV below) and you smoke, you are twice as likely to have pre-cancerous cells in your cervical screening test, or to get cervical cancer. The Langerhans cells are less able to fight off the virus and protect the cervical cells from the genetic changes that can lead to cancer.

UK studies show that 7% of cervical cancer cases are linked to smoking.

There are immediate health benefits to quitting smoking. You don’t need to go it alone- there is plenty of support waiting for you! The HSE Quit team are there to help you quit smoking for good! You can call 1800 201 203, free text QUIT to 50100 or visit their website at www.quit.ie.

Practice safe sex

Most cases of cervical cancer are linked to an infection with certain types of human papilloma virus (HPV). HPV can be spread through unprotected sex, so using a condom can reduce your risk of developing the infection. However, this will not eradicate the risk entirely as the virus can be transmitted during other types of sexual contact, such as skin-to-skin contact between genital areas.

The earlier you start having regular sex and the more sexual partners you have, the higher your risk of developing a HPV infection is. However, it is important to note that women who have only had one sexual partner can also develop it. As such, anyone who is sexually active should have cervical smear tests.

You can read more about HPV in the section, below.

Make sure your daughter gets the HPV vaccine

The Human papilloma virus (HPV) is a major cause of cervical cancer. There are over 100 types of HPV. At least 15 types of HPV are considered high risk for cancer of the cervix - they include types 16 and 18. These 2 types cause about 7 out of 10 cancers of the cervix (70%). If you have persistent infections with high risk types of HPV, you are more at risk of developing pre-cancerous cervical cells or cervical cancer.

HPV is common. Most sexually active women will come into contact with at least one type of HPV during their lifetime. But for most, the virus causes no harm and goes away on its own. So other factors must be needed for cancer to develop. If men use a condom during sexual intercourse, this reduces the risk of a woman becoming infected with HPV. Women can also protect themselves by using the female condom.

There are now vaccines to prevent HPV infection. It is available free of charge from the HSE for all girls in 1st year of second level school. The HPV vaccine may protect girls from developing cervical cancer when they are adults.

These vaccines protect against the strains of HPV that are most likely to cause cervical cancer. But they don't protect against all strains. It will take some years before the introduction of the vaccine has a major effect on reducing the number of cases of cervical cancer. So it is important to emphasise that it is still very  important to carry on with cervical cancer screening.

Remember, even vaccinated women need to continue cervical screening – as it is still important to monitor for other types of cervical cancer and other types of HPV exposure.


Frequently asked questions:

Should women under 25 be screened?

Countries such as New Zealand follow a recommended screening programme from the age of 20 and Finland commence their screening programme at age 30. The age for onset of screening varies across countries. Other countries like Canada recommend screening as soon as a woman becomes sexually active. The World Health Organisation (WHO), the IARC and European Guidelines recommend screening women starting from age 25 as is in Ireland. The WHO supports this position based on evidence that HPV infection is very common in young women but most infections are transient and that cervical cancer is rare before the age of 30. The WHO states that screening younger women will detect many lesions that will never develop into cancer, will lead to considerable over treatment and so is not cost effective.

Should lesbian and bisexual women go for cervical screening?

Yes. All women, regardless of their sexual orientation, who are over 25 should have regular cervical screening. Most cervical abnormalities are caused by persistent infection with HPV. As HPV can be transmitted through skin-to-skin contact in the genital area, gay women are equally at risk of contracting HPV and experiencing abnormal cervical changes and, thus, should always attend when invited for cervical screening.

If I am over 45, married or no longer sexually active do I still need to attend CervicalCheck?

All women, no matter what their age or status, should attend for a cervical smear test. Regardless of whether you are currently sexually active or not, any women who has been sexually active in the past should continue to go for regular cervical smear tests. Cervical cancer is caused by the HPV virus. Anybody who has ever been sexually active is at risk of contracting HPV. HPV is transmitted through skin to skin contact of the genital area, so if you are having sex (or have had sex in the past) you could be at risk of HPV and cervical cancer.

As such, women who are single, married, separated, divorced, and widowed women should all attend for regular cervical smears if they have ever been sexually active in the past.

If someone in my family has cervical cancer, am I at higher risk? 

Women who have a close relative (mother, sister, aunt) with cervical cancer have a higher risk of developing cervical cancer. If you have a close relative with cervical cancer, tell your GP or nurse, and ensure that you attend for regular cervical smear tests. Be aware of the symptoms of cervical cancer and go to your GP if you notice any of them or are worried.

Does an abnormal cervical screening mean I have cancer?

No. The vast majority of cervical screening results are normal, but a very small percentage (about 5%) of the total screenings reported on every year are described as being either 'inadequate' or having a grade of abnormality. The majority of these abnormalities reflect precancerous changes in the cells of the cervix, not cancer.

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