Cervical Cancer

Cervical cancer is cancer that starts in the neck of the womb (the cervix).

Cervical cancer: the facts

  • Around 284 women are diagnosed with cervical cancer in Ireland each year.
  • Women aged 25 to 60 are invited to take part in free cervical screening.
  • Cervical cancer is preventable- smear tests can prevent over 80% of cervical cancers.
  • Smear tests are quick and painless. They could save your life.
  • Smear tests can detect changes in your cervix before they become cancerous.
  • 99% of cervical cancers can be traced back to HPV

The cervix and cervical cancer
The cervix is another name for the neck of the womb. The womb and cervix are part of a woman’s reproductive system, which is made up of:

  • the vagina
  • the womb, including the cervix
  • the ovaries

 

Cervix
The cervix. Image used with permission from Cancer Research UK

The cervix is the opening to the womb from the vagina. It is a strong muscle. Normally it is quite tightly shut, with only a small opening to let sperm in and the flow from a period out of the womb. During labour, the cervix dilates to allow delivery of the baby.

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

The area where cervical cells are most likely to become cancerous is called the transformation zone. It is the area just around the opening of the cervix. This is the area that your doctor or nurse will concentrate on during cervical screening.

Risks and causes of cervical cancer

The majority of cases of cervical cancer can be prevented. Going for regular, free cervical screening through CervicalCheck is the best way to ensure that your cervix is healthy.

• Sexual History
Women who had sex at a young age or have had several sexual partners have a higher risk of developing cervical cancer as they are more likely to develop Human Papilloma Virus (HPV) infection. But HPV is a common sexually transmitted infection (STI) which can affect anyone who has ever been sexually active. Condoms and diaphragms help protect against many STIs.

• HPV infection
HPV can cause genetic changes in the cells covering the cervix that make them more likely to become cancerous in time. As such, it is still important to carry on with cervical cancer screening even if your first smear comes back clear. For more information on HPV, click here.

• Smoking
If you smoke, you are more likely to develop cervical cancer. There are cells in the lining of the cervix (Langerhans cells) that specifically help fight against disease but these cells do not work so well in smokers.

• Family History
Women who have a close relative with cervical cancer have a higher risk of developing the disease.

What to look out for
Pre-cancerous cells in the cervix do not have any symptoms which is why it is vital to go for regular smear tests, even if you feel healthy. If the smear tests show that the cells in your cervix are pre-cancerous, your cervix can be treated before cancer ever develops.

Cancers which are found early are the most easily treated. It makes sense to know how your body normally looks and feels.
The most common symptom of cervical cancer is bleeding from the vagina at times other than when you are having a period. You may experience:

• Bleeding between periods
• Bleeding after or during sex
• Bleeding at any time after the menopause
• A vaginal discharge that smells unpleasant
• Discomfort or pain during sex

It is important to note that there are many conditions which can cause these symptoms, many of which are more common than cervical cancer. However, if you experience any of the above, you are advised to see your doctor to be sure.

CervicalCheck– the national cervical screening programme

CervicalCheck is a government funded service that provides free cervical screening every three years to women aged 25-44 and every five years to women aged 45-60.

To avail of this free test, women can arrange an appointment with any of the 4,500 doctors or nurses registered with CervicalCheck nationwide. To identify a GP practice or clinic, visit www.cervicalcheck.ie or Freephone 1800 45 45 55. Women who have already participated in CervicalCheck will be automatically reminded by letter when their next smear test is due.

How to prevent cervical cancer – HPV cervical screening 

Cervical screening is a way of preventing cancer by finding and treating early changes in the cervix. These changes could lead to cancer if left untreated.

On 30 March 2020, the HSE plans to introduce HPV (Human Papilloma Virus) cervical screening. This is a new way of cervical screening and will replace the current screening test known as ‘The Smear’. The way this new test will be taken will remain the same as the smear test. HPV cervical screening will be the primary screen done from 30th of March onwards. Where a woman is found to be HPV positive following primary HPV screening, a follow-up test using liquid-based cytology will be carried out on that same sample to inspect for cellular abnormalities.

The current system of smear tests looks for changes to cells of the cervix. HPV cervical screening is more accurate and looks for the presence of HPV). HPV is a very common virus. Around 8 out of 10 people will be infected with the virus at some point in their lives. It’s important to remember that it usually doesn’t cause any symptoms, and most people will never know they had it. It usually clears without treatment, however, some types of HPV (high risk HPV) can cause changes in the cells of the cervix that can later develop into cervical cancer.

The new HPV cervical screening test will identify more people at risk of cervical cancer. Cervical screening is one of the one of the best ways to protect yourself from cervical cancer. If your screening test is due before March 30th, you should still attend your appointment.

More information on HPV cervical screening will appear on this website at a later date and on the HSE website.

 

Human Papilomavirus School Immunisation Programme

 

The HPV vaccine has been offered to girls in their first year of secondary school since 2010. This is because the most common cancer caused by the HPV virus is cervical cancer which only affects women. Since September 2019, boys have also been offered the HPV vaccine (Gardasil 9). This is because HPV causes cancers and genital warts in boys too. The more young people vaccinated – both boys and girls – the better we can control the spread of infection caused by HPV viruses.

In girls, HPV infection can cause cancer of the:

  • cervix
  • vulva (the area surrounding the opening of the vagina)
  • vaginal
  • anus
  • throat
  • head and neck

 

In boys, HPV infection can cause cancer of the:

  • anus
  • throat
  • penis
  • head and neck
  • HPV infection can also cause genital warts in both girls and boys.

 

Gardasil 9 vaccine is the current vaccine been offered to both boys and girls in first year of secondary school. Gardasil 9 provides girls with protection against a total of 9 HPV types which are responsible for about 75 to 90% of all cases of cervical cancer’.

If you would like further information about the HSE school HPV immunisation programme please visit the following website:  https://www.hse.ie/eng/health/immunisation/pubinfo/schoolprog/hpv/hpv-vaccination-programme/

For more information on the HPV virus and HPV vaccine, click here.

Further information
If you would like to download a copy of the Marie Keating Foundation’s information leaflet on cervical cancer, please click here.

To download a free Don’t Fear the Smear infographic, click here.