Cervical Cancer Screening

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CervicalCheck - Our national cervical screening programme

CervicalCheck is the National Cervical Screening Programme in Ireland which provides free cervical screening to all women or people with a cervix aged 25 to 65.  If you are on the CervicalCheck register, you will automatically receive a letter to inform you when you next cervical screen is due. When you receive this letter, you can book your cervical screen with your local CervicalCheck registered GP or well women’s clinic. For a list of registered practices, click here.

If you or someone you care for has a disability or need additional support to take part in CervicalCheck, Email [email protected] or Free phone: 1800 45 45 55.

You do not need to be on the CervicalCheck register or to receive a letter to have a cervical screen. If your screening test is due or you missed your last cervical screening test, you can just go ahead and phone your doctor or clinic and make an appointment to have it done.

If you have any concerns about your cervical health or notice any symptoms you should contact your GP immediately.

What is HPV cervical screening?

HPV cervical screening is a new way of cervical screening which was introduced in Ireland in 2020. It has replaced the previous screening test known as ‘The Smear’. This type of screening has already been introduced in Australia, England and Wales.

This way of screening:

  • Is a better way of cervical screening
  • Identifies more people at risk of cervical cancer
  • Means some people will have fewer tests

The changes you may notice in this new way of cervical screening is that:

  • Most women and people with a cervix aged 30 – 44 will now have a screening done every 5 years instead of every 3 years
  • All eligible women and people with a cervix will now be screened up to the age of 65 instead of age 60. Screening has been extended to the age of 65

If you have had a smear in the past, having a new cervical screening test will feel the same as it is taken in exactly the same way.

During the cervical screening test, a small sample of cells is taken from your cervix. The sample is tested to see if you have any of the high-risk types of human papillomavirus (HPV), a virus that can cause cervical cancer.

If HPV is found, your same test sample will be checked to see if you have any abnormal (pre-cancerous) cells in your cervix. It is important to note that pre-cancerous cells are not cancer.

Finding HPV or abnormal cells early means you can be monitored or treated, if treatment is necessary. This helps to decrease the risk of cervical cancer developing.

Like all screening tests, HPV cervical screening is for people who are healthy and who do not have symptoms.

Cervical screening is not a test for cancer, it is a test to help prevent cancer from developing. HPV cervical screening looks to see if you might be at risk of developing cancer in the future, hence it can be effective in reducing your risk of cervical cancer.

No screening programme is perfect and HPV cervical screening is not perfect. Some people will still develop cervical cancer despite regular cervical screening. HPV cervical screening can reduce the risk of cervical cancer developing but it cannot and does not eliminate it completely. However, it is important to attend for cervical screening as it is one of the best ways to protect yourself from cervical cancer.

Since CervicalCheck started in 2008:

  • More than 3 million screening tests have been carried out
  • There has been a decrease in the number of people who develop cervical cancer
  • Over 100,000 cases of abnormal cervical cells have been detected, many of those could have developed into cervical cancer if they had not been detected through screening and treated where necessary

How often then will I be offered a HPV Cervical Screen?

  • People aged 25 – 29 will now be offered a HPV cervical screen every 3 years
  • People aged 30 – 65 will be offered a HPV cervical screen every 5 years

Women and people aged 25 – 29 are screened more often because they are more likely to have HPV.

What happens to my sample?

Your sample will be sent to a quality-assured laboratory (lab). Your sample will be tested in the lab to see if you have a high risk HPV infection. If HPV is found, two experts will examine your sample for cell changes. If cell changes are found you will require a follow-up test called a Colposcopy.

 

What is a Colposcopy?

A Colposcopy is a more detailed examination of your cervix. It is free when you are referred though the CervicalCheck screening programme and is carried out by a doctor or nurse in hospital, usually in the out-patient departement. It usually takes about 15 – 20 minutes. It helps decide if you need treatment to remove abnormal cells if present.

  • If it's obvious that you have abnormal cells, you may have treatment to remove the cells at the same time as your examination.
  • If it's not clear if you have abnormal cells, a biopsy sample may be taken and sent to a lab. You'll need to wait until you get your biopsy results to have treatment.

 

Preparing for a colposcopy

At least 24 hours before your appointment you should avoid:

  • Using vaginal lubricants or creams
  • Having sex
  • Using tampons
  • Douching (washing inside your vagina)

You can eat and drink as normal before your colposcopy.

You may have some light bleeding or discharge afterwards so bring a panty liner with you just in case.

Contact the clinic in advance if:

  • You have your period as your appointment may need to be rescheduled
  • You are pregnant - a colposcopy is safe but you may have to delay treatment
  • You want the examination done by a female doctor or nurse

You can also bring a family member or friend with you for support. A nurse will be present for the procedure.

 

What happens during a colposcopy?

A colposcopy is done by a specialist called a colposcopist. This may be a doctor or a nurse.

During the procedure:

  • You undress from the waist down - you may not need to remove a loose skirt. You lie on your back on an examination bed
  • If you can't get into that position for any reason, the colposcopist may be able to do the examination with you lying on your side with your knees drawn up
  • A device called a speculum is gently put into your vagina - this is similar to having a HPV screening test (previously called the Smear)
  • A microscope with a light is used to look at your cervix
  • Special dye is applied to your cervix to highlight any abnormal areas
  • A small sample of tissue (a biopsy) may be removed for closer examination in a lab – this may be a bit uncomfortable

 

What happens after a colposcopy?

After a colposcopy you:

  • Will be able to go home as soon as you feel ready, usually straight afterwards
  • Can return to your normal activities immediately, including work and driving
  • You may experience a brownish vaginal discharge, or light bleeding if you had a biopsy - this is normal and should stop after 3 to 5 days
  • Should wait until any bleeding stops before having sex or using tampons, vaginal medications, lubricants or creams
  • If you have had a biopsy, it will be checked in a lab. You'll get your results by post.


HPV School Vaccination Programme in Ireland

The HPV vaccine has been offered to girls in their first year of secondary school since 2010. 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 that are vaccinated against high risk HPV – 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 click here.

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