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As cervical screening attendance falls to a 20 year low, it’s time to address the misconceptions

Posted: 12/06/2019

This week, 10 to 16 June 2019, is cervical screening awareness week and Penningtons Manches is joining charities such as Jo’s Cervical Cancer Trust in the campaign to help women to understand the importance of cervical screening.

In our last article it was noted that cervical cancer is preventable in 99.8% of cases. However, preventability depends upon the engagement of women with the cervical screening process which is why it is so important that all women attend their smear test when invited.

However, attendance for cervical screening is currently at its lowest in 20 years with the latest figures suggesting that more than one in four women are not attending their cervical screening when invited.

This article looks at the misconceptions of cervical screening and tries to understand why women are not attending when cervical cancer is the most common form of cancer in women under 35.

The 10 misconceptions of cervical screening

Cervical screening and smear tests are different
No, they are just two different names for the same test.

It is more important for older women to attend for cervical screening
This is incorrect. Cervical cancer affects women of all ages. However, it is the most common cancer in women under 35.

Women who have had the human papillomavirus (HPV) vaccine do not need to attend
This is incorrect. The HPV vaccine has been offered to girls in schools in the UK since 2008. It aims to provide protection against 70% of cervical cancers but, although the vaccine reduces the risk of cervical cancer, it does not protect against every type of cervical cancer.

For this reason, cervical screening is important even for those women who have had the HPV vaccine.

Women who are pregnant should avoid cervical screening
It is recommended that women who are pregnant do not undergo cervical screening.  It is advised that the test is instead carried out three months after the baby is born.

However, if a woman has had an abnormal result before becoming pregnant, her doctor or midwife may recommend that a smear test is performed at the first antenatal appointment. The test will not affect the pregnancy.

The test is embarrassing
Jo’s Cervical Cancer Trust has found that embarrassment has caused over a third of young women to put off their smear test. But there should be nothing to be embarrassed about. Cervical screening is a necessary test for any woman.

Smear tests are performed by qualified nurses who are professionals and perform hundreds of smear tests every year. Before the test, a nurse will give you some privacy to undress from the waist down. They will also give you a sheet to cover yourself during the test. Do not be afraid to request this if it is not offered.  You can also request that a friend or family member attends the test with you if this would make you feel more comfortable.

A story recently published revealed that a beauty salon was offering free bikini waxing as a means of encouraging women to attend their smear tests. Many women are shocked that people are willing to have a bikini wax but are reluctant to have a smear test which could potentially save their life.

The embarrassment of undergoing the test also has to be balanced against the implications of what could happen if the smear test is not performed and potentially cancerous cells are undetected and allowed to develop.

The test is painful
A smear test should not be painful but every woman’s body is different. If you experience discomfort, tell your nurse. They can try to make it more comfortable by using a smaller speculum (the device used to widen the vagina to allow the test to be properly performed). The nurse can talk you through the process to reassure you of what will happen.

You will need to lie down in a comfortable position for the test. This can either be on your back or on your side. Just tell the nurse what you feel more comfortable with.

Once comfortable, a nurse will insert the speculum into the vagina to open it so that the cervix is visible. This part of the test might feel uncomfortable but it should not be painful. Then, using a soft brush, the nurse will quickly take a small sample of cells from the cervix by rotating it a few times before removing the speculum.

The sample of cells will be placed into a small plastic container of liquid to preserve them. This is then sent off to a laboratory to be tested.

An abnormal result means you have cancer
Many women have explained that part of the reason they have not attended their screening is the fear that the result could show abnormalities.

A smear test is not a test for cancer. It is a test that can prevent cancer. In 94% of cases, smear tests are reported as normal and the majority of those who are found to have abnormal cells will have pre-cancerous changes in the cells rather than cancer.

Does cervical screening check how healthy the ovaries, womb or vagina are?
No, cervical screening only looks at the cervix. It will not look for any problems in the ovaries, the womb, the vulva or the vagina. Cervical screening will therefore not test for ovarian cancer.

It should also be noted that a smear test also does not test for sexually transmitted infections.

Women who are lesbians, bisexual or transmen do not need to have a smear test?
This is incorrect. Anyone who has a cervix should be offered a smear test.

There is a misunderstanding that the HPV can only be contracted through penetrative sexual intercourse with a man. While this is the most common way in which the HPV virus is contracted, it can be contracted through other means.

Women who are not sexually active do not need screening
It is a myth that you do not need a smear test if you are not currently sexually active. Anyone women who has been sexually active at any time during her life should undertake cervical screening.

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