Why is a smear test important?
Having cervical screening is hugely important. Data from Public Health England states that cervical cancer mortality rates have decreased by up to 70% since the introduction of the NHS cervical screening programme in 1988. Having said that, in recent years, cervical cancer has become the most common cancer among women under the age of 35. Attending for screening is absolutely crucial.
What is a smear test?
A smear test is a simple, easy way to detect changes in the cells at the neck of your womb (cervix) that may lead to cancer if left undetected, unmonitored and untreated. The NHS offers cervical screening for all women aged between 25 and 64. It checks for ‘high risk HPV’ (human papilloma virus). HPV has many different types but some high risk types can lead to changes in the cells of the cervix that can progress to cancer. Most cervical cancers are associated with underlying high risk HPV. This is different to the types of HPV that can cause genital warts.
If HPV is detected on your smear test, the laboratory will go on to check the cells in the sample to see if there are any changes (cytology). In the NHS, you will be called for a smear test every 3 years up until the age of 49 and then every 5 years from the ages of 50 to 64.
If HPV is detected on your smear test, but there are no changes in the cells when they are checked, you will be invited back for a repeat smear test in 1 year and then again in 2 years if you still have HPV. If HPV is still present after 3 years, it is likely that you will be referred for a colposcopy.
If HPV is detected on your smear test and abnormal cells are found on cytology, you will be referred straight for a colposcopy.
What is a colposcopy?
A colposcopy is a procedure that is normally done at the hospital by a gynaecologist. It is quite similar to a smear test but it allows the specialist to look at your cervix under magnification and detect any changes in the cells that might need treatment. Sometimes, a small sample may be taken (a biopsy) for testing.
Why does the NHS cervical screening programme test for HPV and only check the cells if it is positive?
You may think that it is more accurate to check the cells straight away but actually, studies have shown that testing for ‘High Risk HPV’ the most sensitive way of detecting patients who may go on to develop changes in the cells of the cervix, especially high grade changes. It is possible that you could have changes in the cells without HPV, but this is far less likely and, if even this was the case, the changes are less likely to progress to anything serious.
What is different about having a smear in a private clinic?
There is no real difference in the way we take your smear or the way that it is processed. If you’re feeling nervous or worried then we do have longer appointment times to make sure that you are comfortable and happy to proceed.
As with anything in private healthcare, it is all about choice. You may choose that you would like a smear outside of the NHS screening programme allowances, i.e. before the age of 25 or after the age of 64. You may have had some abnormal bleeding and want to check that everything is okay now rather than waiting to be called. It may also be that you want to choose to have HPV and cytology testing in one – even if your sample is HPV negative. At Kent Family Medical, we would never recommend only testing the cells (cytology), but you may which to check for HPV and cytology, for peace of mind.
If you do have a private smear test, you will not be taken out of the NHS national screening programme. You will still be invited at regular intervals. If you wanted to have a private smear test instead of having your routine smear within the NHS, this is fine as well. We will always share the results with your NHS practice to ensure that your health record is complete.