Having a smear test
The smear test is a method of screening that detects pre-cancerous changes in a woman's cervix (the neck of the womb).
Why have one?
A smear test can pick up abnormal changes in cervical cells, which are usually easy to treat if they are caught at an early stage, but it is not a test for cancer itself. It can also find signs of some hidden infections such as HPV, which is a form of wart virus that's been linked to cancer of the cervix.
Who should have them?
The policy on when to give a woman her first smear test has recently changed due to the fact that cervical cancer is so rare in young women. Research revealed that most abnormalities showing up on smear tests in the under 25s were rarely linked to cervical cancer. This lead to a large number of young women going through a long and upsetting process of unnecessary tests and treatment, so the decision was made to start testing later.
A woman's chance of developing cervical cancer is significantly reduced if she's never had any sexual partners. There's still a small chance, so it's worth getting tested regardless, but if you haven't been sexually active you can choose to decline the smear test appointment if you want to. If you've been sexually active in the past and have recently had a 'dry spell', it's recommended that you get tested as normal.
Your GP (doctor) will send you a letter when you're 25 asking you to book an appointment for a smear test. If the smear shows nothing abnormal, the test is repeated at three year intervals. Note that you cannot be screened during your period. The best time to have the test is roughly two weeks after the first day of your period.
What are they like?
The test is very simple and quick. The woman lies on her back with her knees apart and her heels up towards her bottom. The doctor or nurse inserts a sterile instrument called a speculum into the vagina to make the cervix easier to see. A tiny spatula is then used to gently scrape some cells from the cervix. Sometimes a very small brush can be used too. The whole process should be painless, but can sometimes be a bit uncomfortable, especially if you're nervous.
A quick pelvic examination is sometimes carried out afterwards at some clinics, with the doctor or nurse using a gloved hand to check the vagina, womb, and ovaries. You may also be offered a blood pressure test and breast examination. Some women find they bleed slightly after a smear, so it's a good idea to have a small sanitary towel or panty liner in your bag, just in case.
Vaccine against cervical cancer
A vaccine has been introduced to protect against the Human Papilloma Virus (HPV), which can increase the risk of developing cervical cancer. HPV is a virus that is passed on by sexual activity and there are more than 100 different types, including genital warts.
The Government has announced that the vaccine is now being introduced to 300,000 girls aged 17 to 18 in September 2008, as well as all 12 to 13 year-olds. Many more young women aged 15 to 18 will be offered the vaccine in September 2009.
The vaccine will protect against the two strains of the HPV virus that cause 70% of cases of cervical cancer, the second most common cancer in women worldwide. There are two different types of vaccine, Cervarix and Gardasil, and it's Cervarix that is being offered to young women from September. However the choice of this vaccine has been widely criticised as it doesn't protect against genital warts. The vaccine is also available in private clinics at a cost of around £250.
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