Cervical health screening was introduced in 1990 to assist in reducing the number of women who develop cervical cancer. The programme encourages women to have regular cervical smears tests to detect changes in the cells of the cervix. The cervical smear test is not a test for cancer. It is a screening test to look for early cell changes before they can become cancer.
The National Cervical Screening Programme recommends that all women who have ever been sexually active have regular cervical smears tests from the time they turn 20 until they turn 70. Some older women may think that it is not necessary especially if they are no longer sexually active. However as cervical cells change slowly there is still a possibility that they may develop cervical cancer. Four out of 10 women who die from cervical cancer are over 65 years of age.
Women are advised to have a cervical smear test every three years unless advised otherwise.
The smear taker should first tell you how it is done, about the National Cervical Screening Programme and about your tests results.
For the smear test, the smear taker will slide a plastic or metal instrument called a speculum into your vagina. This is to hold the vagina open so they are able to see the cervix and take the smear from the correct place. They will then take a sample of cells from the cervix by lightly scraping or brushing with a thin wooden spatula or a tiny plastic broom. It will only take a few minutes to take the actual smear. Cells are then smeared onto a slide and sent to the laboratory for examination.
A few suggestions for when you have a smear test from the National Screening Programme literature include:
- you can take a support person with you when you have a smear test done
- if it hurts then please tell the smear taker
- as an older woman, your cervical smear test may be more uncomfortable because of changes in your vagina, it may be helpful to put some oestrogen cream in the vagina for two weeks before the test
- if you want a sheet or blanket to cover yourself and it is not offered, ask for one.
A doctor or approved nurse or lay non-medical smear taker can take a smear. Smear-taking must be provided in a way acceptable to women, including access to a smear taker of their choice. It is also desirable that women have access to a smear taker of their cultural group, if they wish. Maori women can access cervical smear takers who are Maori women.
Women can contact their regional cervical screening programme for names of approved smear takers in their area.
Over one million women have enrolled in the National Cervical Screening Programme Register (NCSP-Register). Being part of the programme means:
- a record of your cervical smear test information is available to you, your smear taker and the laboratory reading the test.
- you are automaticallly sent a reminder letter if your cervical smear test is overdue.
- the NCSP Register provides a back-up system to check that you receive appropriate follow-up if you have had an abnormal smear.
- information on the NCSP Register can be used to check how well the programme is working for all women.
There are two main types of cervical cancer:
- squamous cell cancer
- adenocarcinoma (or glandular cell cancer)
The most common, accounting for around 90 percent of cases, is squamous cell cancer. The pre-cancerous phase is gradual. A few cells of the epithelium, the cervical skin, become mildly abnormal. These cells often return to normal. However the cells sometimes progress to high grade abnormalities. At each stage more and more cells become abnormal. It is not until the cells have breached the basement membrane, or bottom of the skin layer, that cancer is capable of spreading to other parts of the body. This usually takes 15 years.
Without treatment high grade abnormalities may develop into invasive cancer. Both invasive cancer and precancerous changes are associated with some of the 70 or so human papillomavirus (HPV). HPV infections are usually acquired sexually often without women knowing that they are infected. A few women may notice the infection i.e. genital warts.
It is important to see your doctor if you notice any of the following signs:
- bleeding after menopause
- bleeding after sexual intercourse
- bleeding between periods
- an unusual discharge from your vagina.
Whilst these do not exclusively indicate cervical cancer, they may be a sign of other ill-health. Please get them checked.
The website for the National Screening Programme is part of the National Screening Unit website. It is an excellent resource for further information on cancer screening and cervical cancer. You can also telephone the Cervical Screening Programme on 0800 729 729. There are quality standards for the programme. The standards can be viewed National Screening Unit site.
The Everybody website has a variety of information on this topic.
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