1. Cervical cancer & screening

2. Objectives What is cervical cancer? Who gets cervical cancer?
Can it be prevented?
What treatment is available?

3. Quiz time!
Which viral infection is the most common cause of cervical cancer?
HIV
Human papilloma virus (HPV)
Herpes

4. Quiz time! Which viral infection is associated with cervical cancer?
HIV
Human papilloma virus (HPV)
Herpes
Do you remember getting a vaccination at school when you were 12? That was to protect you against this virus.
HPV is a sexually transmitted virus that is linked to almost 100% of cases of cervical cancer

5. Cervical cancer cannot be prevented.
True
False
Cervical cancer only affects older women.
True
False

6. Cervical cancer cannot be prevented.
True
False
Cervical screening can help prevent cervical cancer
Cervical cancer only affects older women.
True
False
60% of cases are in women aged 25-49

7. What is the cervix?
The cervix is the neck of the womb.

8. What is cervical cancer?
- Cancer that affects the surface of the cervix
- 1 in 135 women will be diagnosed in their lifetime

9. Who can get cervical cancer?
Human papilloma virus (HPV) is the most important cause of cervical cancer
Body usually fights the virus, BUT
Infection is very common so prevention is important
Barrier contraception
All girls aged should be vaccinated against HPV

10. Factors that increase your risk
Women with multiple sexual partners
Younger women
Smoking
Missing smears
60% of cases around the world happen in women who have never been screened!

11. Busting myths Myth #1 Cervical cancer cannot be prevented
Cervical cancer is one of the most preventable cancers!
It is unique in that there is an early pre-cancerous stage that can be picked up by screening
This can then be treated

12. The screening programme
Number of cases has decreased by a third!
If you live in England, you will get your first invite at age 25
You will be asked every 3 years up until age 49
Woman aged 49 – 64 are checked every 5 years

13. I have no symptoms so I don’t need to worry about going for screening
Myth #2
I have no symptoms so I don’t need to worry about going for screening
Screening is used to detect any cell changes within the cervix that have a risk of developing into cancer
If left untreated, these cells are at greater risk of becoming cancerous
Abnormal cells can be detected long before any symptoms develop, which is why screening is so important!
Symptoms to look out for include:
Bleeding in between periods
Bleeding after sex
Unpleasant discharge
Do they know what discharge is? Unpleasant- funny smell/colour.

14. Myth #3
Cervical cancer only affects older women

15. In fact…
The number of women being diagnosed with cervical cancer aged has more than doubled in recent years
Screening.
WHY?

16. Only 63.5% of 25-29 year olds have a smear

17. There are many reasons why people may not attend
‘Smear tests are embarrassing’
‘I worry that a smear test will be painful’
‘I’m scared of what a smear test might find’

18. What to expect Booking your test
You'll receive a letter through the post asking you to make an appointment for a cervical screening test. The letter should contain the details of the place you need to contact for the appointment.
Most women choose to go to their GP practice, although it may also be available at a well woman clinic or sexual health clinic. Screening is usually carried out by the practice nurse. You can ask to have a female doctor or nurse.
If possible, try to book an appointment during the middle of your menstrual cycle (usually 14 days from the start of your last period), as this can ensure a better sample of cells is taken.
If you use a spermicide, a barrier method of contraception or a lubricant jelly, you shouldn't use these for 24 hours before the test, as the chemicals they contain may affect the test.
Your screening appointment
The cervical screening test usually takes around five minutes to carry out. You'll be asked to undress from the waist down and lie on a couch, although you can usually remain fully dressed if you're wearing a loose skirt.
The doctor or nurse will gently put an instrument, called a speculum, into your vagina. This holds the walls of the vagina open so the cervix can be seen. A small soft brush will be used to gently collect some cells from the surface of your cervix.
Some women find the procedure a bit uncomfortable or embarrassing, but for most women it's not painful. If you find the test painful, tell the doctor or nurse, because they may be able to reduce your discomfort. Try to relax as much as possible, because being tense makes the test more difficult to carry out. Taking slow, deep breaths will help.
The cell sample is then sent off to a laboratory for analysis and you should receive the result within two weeks.

19. What you might be told after a smear
Normal
Abnormal
95% of tests will show normal cells
Remember: an abnormal result does not necessarily mean you have cancer!
You will be informed of the next steps in the process eg continue screening/further investigate/removal
Borderline/low grade changes tested for HPV and if +ve, sent for colposcopy. NB in some areas, it is tested for HPV 1st, then only if +ve the cells are looked at.
If significant changes then straight to colposcopy, no HPV testing.
?HPV
POSITIVE/NEGATIVE