Cervical Smear Tests for Women
The National Cervical Screening Programme is a Government-funded service that provides free smear tests to women aged 25-60. This has been introduced in Ireland in September 2008 and is available to all patients at the Womens Health Clinic. In order to be eligible for the programme you need to pre register at freephone 1800 454555 or online at www.cervicalcheck.ie
What is cervical screening?
Cervical screening tests women for changes in the cells of the cervix (neck of the womb) by a smear test.
What is a smear test?
A smear test (sometimes called a pap test) is used for cervical screening. It is a simple procedure where a doctor or nurse (smeartaker) takes a sample of cells from the cervix (neck of the womb) to look for early changes. A smear test can identify cell changes before they become cancer cells. If these cells are not found and treated, they could become cancerous.
Who should have a smear test?
Every woman aged between 25 and 60 should have a regular smear test and continue to have regular smear tests after the menopause. If you are aged over 60 years and have never had a smear test, please contact the clinic to discuss your cervical screening needs. A woman over 60 who has not had a free CervicalCheck Programme smear test is entitled to do so.
Why should I have this test?
Quite simply, having a regular smear test could save your life.
When is the best time to have a smear test?
The best time to attend for your smear test is mid-cycle – that is, 10 to 14 days after the first day of your period (if you are having periods).
How is a smear test taken?
A smear test is a very simple procedure that takes less than five minutes. It may be slightly uncomfortable but should not be painful.
You may lie on your side or on your back for your smear test. The doctor or nurse taking the test will gently insert an instrument called a speculum into your vagina to hold it open. The cervix is the area where the top of the vagina leads to the uterus (womb). The doctor or nurse will use a small, specialised brush to gently remove a sample of cells from the cervix. This sample is sent to the laboratory to be checked.
What if I’ve had a hysterectomy?
If you have had a hysterectomy, you should check with your doctor to see if you need to continue having regular smear tests. In general, the need to screen after a hysterectomy will depend on whether you have a cervix.
How often should I have a smear test?
After the first smear test, women aged 25 to 44 will be invited by CervicalCheck to have a free smear test every three years. They will invite women aged 45 to 60 to have a free smear test every five years once they have had two ‘no abnormality detected’ smear test results at three yearly intervals.
CervicalCheck will advise you when your next free smear test is due. If you have any unusual or irregular vaginal bleeding, spotting or discharge, do not wait for your next smear test contact us immediately.
Results
CervicalCheck will send you a letter about your results within six weeks of your smear test. The result of your test will also be available from your smeartaker.
Most smear test results are found to be normal. Please try not to worry if you are called back for another test. The result could be due to an infection or minor cells changes that may or may not need treatment.
If your result is not normal you may need to have another free smear test or a more detailed examination of the cervix using a type of microscope. This test is called a colposcopy. If there are cell changes on your cervix they can be easily treated to prevent them developing into cancer cells.
What is a colposcopy?
A colposcopy is a simple examination that is carried out the same way as a smear test. A doctor or nurse will look at the cervix using a type of microscope called a colposcope. During the examination, a liquid or dye may be applied to the cervix to help identify any changes to the cells. A colposcopy can be done safely during pregnancy.
Before the colposcopy, the doctor or nurse should explain:
- the colposcopy examination,
- the possible treatments for changes in the cells of the cervix, and
- any risks linked to the treatment.
How will CervicalCheck use my information?
They will use your contact details to:
- invite you for a free CervicalCheck smear when your test is due, and
- advise you if any further treatment is needed.
About Cervical Cancer
Cervical cancer is a cancer of the cells of the cervix (neck of the womb). Cervical cancer is the second most common female cancer in Europe. Cervical cells change slowly and take many years to develop into cancer cells, making cervical cancer a preventable disease.
How can I reduce my risk of getting cervical cancer?
- Have a regular smear test to pick up any early problems.
- Stop smoking
- Visit your doctor if you have any concerns or symptoms such as irregular vaginal bleeding, spotting or discharge.
What do the results of the cervical screening test mean?
Normal result
About 9 in 10 routine cervical screening tests are normal. You will be sent a letter inviting you for another one in 3-5 years. (Note: a normal result means you have a very low chance of developing cancer of the cervix – not a 100% guarantee that it will not occur.)
Inadequate test
This sometimes occurs. This simply means no result can be given. For example, if the smear method was used, an inadequate test may occur because there was some blood or too much mucus on the slide and the cells could not be seen properly. Sometimes it is because a smear of cells was too thick or too thin to assess properly. You will be asked to attend for a repeat test. However, with the newer liquid based cytology method, the number of tests that are ‘inadequate’ and need repeating is much less than with the traditional smear method.
Abnormal result
Some changes in the cells are found in about 1 in 10 tests. There is a range of changes that may occur. In nearly all cases, these changes do not mean cancer. Minor or borderline abnormal changes are quite common. These often clear away on their own and most mild changes do not progress to anything serious. However, any change needs to be monitored as some may progress to become more serious in the future. You will be automatically recaleed for a repeat smear after 6 months if your test result is abnormal. Often the changes will have gone when the test is repeated. If the changes do not go, or the changes are more marked, then a referral to colposcopy is advised. Rarely, a cancer of the cervix is diagnosed by a cervical screening test.
Can abnormal cells be treated?
Yes. A minor abnormal change often goes away by itself. This is why a repeat test after 6 months may be all that is needed. If the cells remain abnormal, or the changes are more marked, then treatment is offered. This will stop cancer from developing in the future.
The types of treatments that are used include:
- Cryotherapy – freezing the affected area of the cervix which destroys the abnormal cells.
- Laser treatment – this destroys or cuts away abnormal cells.
- LLETZ (Large Loop Excision of the Transformation Zone) (Loop Diathermy) – a hot thin wire loop cuts through and removes the abnormal area of cells. the edges of any blood vessels cut will be instantly caurerised (sealed) as the wire is hot.
These treatments are done as an out-patient and do not take long. They are usually successful and are usually needed only once. Follow up and regular screening tests are needed for the next few years check that the treatment has been successful. It takes a few weeks for the cervix to heal after treatment. Once it has healed, a normal sex life can be resumed. Treatments do not affect fertility.
