Cervical cancer screening

Overview

Cervical cancer screening is a test that looks for early signs of changes in the cells of the cervix (the lower part of the womb). These changes can sometimes lead to cervical cancer if not treated. The aim is to find and treat them before they become cancer.

Cervical cancer is not common, but it can be serious. Screening helps make it even rarer.

It affects people with a cervix, most often those aged 30 to 45. With regular screening, the number of cases has dropped greatly.

Symptoms

Common symptoms

• Cervical cancer often has no symptoms in its early stages.
• If symptoms do appear, they may include unusual bleeding, such as between periods, after sex, or after menopause.
• You might also have pain during sex or unusual vaginal discharge.

Symptoms in children

• Cervical cancer is extremely rare in children. Screening is not recommended for them.

Symptoms in older adults

• In older adults, symptoms are similar: any bleeding after menopause should always be checked.
• Screening usually stops after age 64 if previous results have been normal.

Causes

Main causes

• Almost all cervical cancers are caused by certain types of human papillomavirus (HPV). HPV is a very common virus that is spread through skin-to-skin contact, usually during sexual activity.

Risk factors

• Having a weakened immune system (for example, from HIV or an organ transplant).
• Smoking tobacco.
• Using birth control pills for many years (5 years or more).
• Having given birth to three or more children.

When to see a doctor

See a doctor urgently if:

• If you have any unusual bleeding from the vagina, especially after menopause.
• If you have bleeding that is heavy or lasts longer than your normal period.

Book a routine appointment if:

• Attend your scheduled screening appointment when invited (usually every 3 to 5 years).
• If you have new pain during sex or unusual discharge, see your doctor promptly.

Diagnosis

Cervical cancer screening involves a simple test called a cervical smear (also known as a Pap test) and/or an HPV test. Your doctor or nurse takes a small sample of cells from your cervix using a soft brush. It takes only a few minutes.

Tests that may be done

• HPV test: checks for high-risk types of HPV in the cells.
• Pap smear (cytology): looks at the cells under a microscope for any changes.
• If either test is abnormal, you may need a colposcopy – a close look at your cervix with a magnifying device.

What to expect at your appointment

The screening is usually done at your doctor’s office or a clinic. You lie on a table with your feet in supports. A speculum (a plastic or metal instrument) is gently inserted to open the vagina. The sample is taken with a small brush. It can be a bit uncomfortable but usually not painful. The whole process takes about 5 minutes.

Treatment

If screening finds abnormal cells (pre-cancer), treatment can remove them before they become cancer. Treatment depends on the type and size of the changes.

Self-care at home

• If you have abnormal results, follow your doctor’s advice for follow-up tests.
• If you smoke, quitting smoking helps your body clear HPV and heal faster.

Medical treatments

Treatment for pre-cancer often involves a small procedure to remove the abnormal cells, such as loop electrosurgical excision procedure (LEEP) or cone biopsy. These are done in a clinic under local anaesthetic. Sometimes a laser or freezing (cryotherapy) is used. For cancer, treatment may include surgery, radiation therapy, or chemotherapy. Your doctor will discuss the best options for your situation.

When is surgery considered?

If pre-cancer cells are found, minor surgery like LEEP is common. If cancer is found, a hysterectomy (removal of the womb) may be recommended, but only after thorough discussion of all options.

Living with this condition

After an abnormal result, you may need more frequent screening or a follow-up colposcopy. Most people continue their normal daily life. If you have treatment, you may need time off work for a day or two.

Lifestyle tips

• Attend all follow-up appointments as recommended.
• If you smoke, get help to quit.
• Consider the HPV vaccine if you haven’t had it (it can prevent future HPV infections).

Diet and exercise

A healthy diet rich in fruits and vegetables and regular exercise support your immune system. No special diet is needed for screening results.

Mental health and emotional wellbeing

Waiting for screening results can cause anxiety. It helps to talk to someone you trust. Most abnormal results are not cancer, and treatment is highly effective.

Prevention

Yes, cervical cancer is one of the most preventable cancers. The HPV vaccine and regular screening are very effective.

Vaccines

The HPV vaccine is offered to pre-teens and young adults, usually around age 12 to 13. It protects against the types of HPV that cause most cervical cancers. It is most effective when given before people become sexually active.

Screening programmes

Regular cervical cancer screening (every 3 to 5 years) can find changes early. Even if you have had the HPV vaccine, you still need screening because the vaccine does not cover all cancer-causing HPV types.

Complications

If left untreated

• Abnormal cells can become cervical cancer over time (often many years).
• If cervical cancer is not found early, it can spread to other parts of the body and become harder to treat.

Long-term outlook

With regular screening, the outlook for cervical cancer is excellent. Most pre-cancer changes are treated easily, and early-stage cancer has a very high survival rate. The number of new cases has fallen sharply thanks to screening and vaccination.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.