Cervical cancer is cancer that starts in the neck of the womb (the cervix).
Cervical cancer: the facts
- Around 300 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.
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
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 smear tests through CervicalCheck is the best way to ensure that your cervix is healthy. You can find out more about smear tests on our page, Don’t Fear the Smear.
• 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.
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 smear tests every three years to women aged 25-44 and every five years to women aged 45-60.
To avail of this free smear 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 – Smear tests and the HPV vaccine
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.
The screening uses a test called cytology, often called a smear test. 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 HPV as this can increase the risk of cervical cancer.
The laboratory examines the cells and reports any abnormal ones. They may also test to see whether the HPV virus is present in the sample.
What the results mean
CervicalCheck will write to you with the result, usually within two weeks of having the test. There are several different results you can have after a screening test. Most women have a normal result. In this case you will be invited for screening again in 3 to 5 years depending on your age.
Some results are due to problems with the test rather than because there are any abnormal cells. You may need a repeat test because the sample was inadequate or could not be read properly. This may be because:
• There were not enough cells in the sample
• You have 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
In all these cases, a letter will ask you to go back and have another test. This is usually about 3 months later. It is very important to follow through with this instruction.
If you have an abnormal result
Around 1 in 20 women (5%) have an abnormal result after a cervical screening test. It means that there are some changes to the cells on the cervix. These changes are not cancer. The cells often go back to normal by themselves. But in some women, if not treated, these changes could develop into cancer in the future. If cancer does develop, your doctor will talk to you about treatment options.
Human Papilomavirus School Immunisation Programme
The HPV vaccine protects girls from developing cervical cancer when they become adults. The vaccine is given through a school based programme, to ensure high vaccine uptake. However, in specific instances some girls will be invited to special HSE clinics for their vaccines. It protects against the types of HPV that cause around 70% of all cervical cancers. As such, it is still important for girls who have been vaccinated to have regular smear tests when they are adults.
HSE will extend the HPV vaccination to boys this year.
In 2018, the Health Information and Quality Authority (Hiqa) published its assessment on the clinical and cost-effectiveness of extending the vaccine to boys. Health Minister Simon Harris later announced that the HSE will extend the HP vaccination to boys next year and has said that funding has already been made available in the budget to facilitate the introduction of the initiative in 2019.
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.
If you have a question about cervical cancer, you can use our Ask the Nurse section by clicking here. This service is confidential and free.