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Smear tests and stigma

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Elinor Jones, Science Editor, busts the myths of cervical cancer

STUDIES have shown an alarmingly low number of women have a comprehensive understanding of cervical cancer, despite nearly 900 women dying yearly in the UK from this form of cancer and with similar survival rates to testicular and skin cancers. With new evidence suggesting a rapid decline in the incidence of HPV-related cervical cancer since the introduction of the HPV vaccine we are cutting through the noise surrounding an often ‘taboo’ subject.
Cervical cancer is a malignancy – an over-proliferation – of the uterine cervical tissue, the entrance to the womb, which has the ability to spread to other tissues and organs of the body. It’s associated with low-lying symptoms that tend not to show until the later stages of the cancer, such as when the cancer spreads to other parts of the body.
However, women can experience vaginal bleeding, notably after sex – although don’t be alarmed if you do experience this as it doesn’t necessarily mean you’ve got cancer, but perhaps get it checked out. Other noticeable changes to bleeding between periods or after menopause.

Cervical cancer is an over-proliferation of cervical tissue

Generally, a way of assessing the health of your cervix is through smear tests, or ‘pap’ smears. Whilst notoriously uncomfortable and incredibly intimate, smear tests involve the crucial element of sampling the health of the cells of your cervix, allowing them to be observed to identify if they’re pre-cancerous, cancerous, or absolutely fine, offered in the UK to all women over the age of 25 every three years. Whilst this is an essential service, rates of uptake for cervical smears are declining yearly, with many embarrassed or concerned about the procedure being painful. And, yes, we’re not saying it is the most comfort you’ll ever experience, but it can detect up to 60% of cancers if performed regularly and within weeks you can be placed on a waiting list.

Smear tests are offered in the UK to all women aged over 25

here is argument as to whether the age of testing should be brought forward, despite it unusual for women of a younger age to get this form of cancer. However, occasionally, younger women experiencing cervical cancer, and seeking advice is the best thing to do.
With fewer women attending screening tests, one positive in the world of cervical cancer is the HPV vaccine.
Introduced in 2008 in schools across the UK, this routine vaccine programme targets the most severe form of most types of cervical cancer caused by HPV, or the Human Papillomavirus. Since its introduction, the vaccine, given to 12- and 13-year-old girls, has resulted in an 89% drop in cases of the most extreme levels of cervical intraepithelial neoplasia (CIN), especially in young women who had not encountered HPV, a sexually-transmitted infection.
Remarkably, even those who haven’t been vaccinated in these programmes have experienced lower rates of CIN, with ‘herd’ immunity due to the reduction in HPV in the community. It is still advised, however, to get vaccinated, and attend regular smear tests from the age of 25.
Unfortunately, as with a lot of medicine, often female-only diseases get little awareness or funding for research. But times are changing. With more knowledge than ever before and more choices than ever before, women are surviving a disease that would previously be deadly in many cases.

The vaccine programme targets the most severe cancer caused by HPV

Whilst things aren’t perfect, they are getting better. As long as we all work together to encourage regular testing, to combat the stigma of the ‘downstairs’ region, and support each other when we need it most.

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