Cervical Screening is the phrase given to regular check-ups from a medical professional, to check that the Cervix is healthy, from the ages of 25 to 64, every three to five years. The Cervix is the narrow opening to the Womb, which lies at the back of the Vagina. Screening is carried out because it is a place that can be seen and checked easily.
The most common screening is a Smear or PAP Test, which involves taking a scraping of the cells that cover the Cervix to make sure they are normal. To do this a person would need to attend a clinic and undergo a vaginal examination, where an instrument called a speculum, is inserted into the Vagina to allow access to the Cervix. This is usually viewed as uncomfortable, but not painful and for those who have not been through pregnancy, it can be embarrassing. Once you have been through pregnancy you generally get used to these types of examinations.
The cells that are collected are then sent off to a laboratory so as they can be checked. The results can lead to several options:
- Normal (negative) result. This means everything is healthy and you won’t need another smear for three years.
- Unclear result. This is common and usually means that not enough cells were available for testing and the test will need to be repeated.
- Abnormal cells. This means that changes were found in the Cervical Cells:
- Atypical Squamous Cells of undetermined significance (ASC-US): This is the most common abnormal Smear Test finding. It means that some cells don’t look completely normal, but it’s not clear if the changes are caused by an HPV infection. Other things can cause cells to look abnormal, including irritation, some infections (such as a yeast infection), growths (such as Polyps in the Uterus), and changes in hormones that occur during pregnancy or Menopause. Although, these things may make Cervical Cells look abnormal, they are not related to Cancer. Your health care provider will usually do an HPV test to see if the changes may be caused by an HPV infection. If the HPV test is negative, Oestrogen cream may be prescribed to see if the cell changes are caused by low hormone levels. If the HPV test is positive, you may need additional follow-up tests.
- Atypical Glandular Cells (AGC): Some Glandular Cells were found that do not look normal. This can be a sign of a more serious problem further inside the Uterus, so your healthcare provider will likely ask you to come back for a Colposcopy. A Colposcopy is very similar to a Smear, but uses a machine with a camera on the end that allows the medical professional to look further into the Cervix and at a more detailed level.
- Low-grade Squamous Intraepithelial Lesions (LSIL): There are low-grade changes that are usually caused by an HPV infection. Your health care provider will likely ask you to come back for additional testing to make sure that there are not more serious (high-grade) changes.
- Atypical Squamous Cells cannot exclude High-grade Squamous Intraepithelial Lesion (ASC-H): Some Abnormal Squamous Cells were found that may be a High-grade Squamous Intraepithelial Lesion (HSIL), although it’s not certain. Your healthcare provider will likely ask you to come back for a Colposcopy.
- Adenocarcinoma in situ (AIS): An advanced lesion (area of abnormal growth) was found in the glandular tissue of the Cervix. AIS lesions may be referred to as Precancer and may become Cancer (Cervical Adenocarcinoma) if not treated. Your healthcare provider will likely ask you to come back for a Colposcopy.
- Cervical Cancer Cells (Squamous Cell Carcinoma or Adenocarcinoma): Cancer cells were found; this finding is very rare for people who have been screened at regular intervals. If a biopsy shows that Cervical Cancer is present, your doctor will order certain tests to find out if Cancer Cells have spread within the Cervix or to other parts of the body.
The cervical screening is offered every three years, or sometimes sooner if a change is noticed. If you have not already been invited, then contact you GP and make sure you regularly attend.
For more information on Cervical Screening, you may find this website helpful: https://www.jostrust.org.uk/