What does the Cervical Screening Program do?
The program aims to reduce the number of women who develop invasive cervical cancer (incidence) and the number of women who die from it (mortality). This is done by regularly screening all women at risk.
In this Health Blog Consultant Surgical Oncologist, Dr Saurabh Mohite explains more about Cervical Screening Program What is cervical screening?
Cervical screening is not a test for cancer. It is a method of preventing cancer by detecting and treating early abnormalities which, if left untreated, could lead to cancer in the cervix. Early detection and treatment can prevent 75 per cent of cancers. The first stage in cervical screening is taking a sample for cytology analysis. The sample cells are collected from the cervix using a special brush. A doctor inserts a speculum to open the woman’s vagina and uses the plastic brush to sweep around the cervix. Most women consider the procedure to be only mildly uncomfortable. The head of the brush, where the cells are lodged, is then broken off into a small glass vial containing preservative fluid, or rinsed directly into the preservative fluid. This process is called Liquid Based Cytology (LBC) and has replaced conventional cytology where smears were taken. The vial of fluid is then sent to the laboratory where it is spun and treated to remove any obscuring material, for example mucus or pus. A thin layer of the cells from the sample is deposited onto a slide. The slide is examined in the usual way under a microscope by a cytologist. Cytology, the study of cells, enables cervical samples to be grouped into different grades. This helps the doctors decide what action should be taken. LBC has reduced the rate of inadequate tests, which has now fallen from over 9 percent before the introduction of LBC, to 2.5 per cent in 2008-09. This means fewer women have to undergo repeat testing, and the anxiety that goes with that. Laboratories can also work more efficiently, so women get their results more quickly.
Who is eligible for cervical screening?
All women between the ages of 25 and 64 are eligible for cervical screening test.
Why are women under 25 and women over 65 not recommended screening?
Cervical cancer screening starts at the age of 25 and this is in line with recommendations made by:
• The International Agency for Research on Cancer, an agency of the World Health Organisation that coordinates and conducts research into cancer
• Cancer Research UK
• The independent Advisory Committee on Cervical Screening.
Screening women under the age of 25 may do more harm than good as it can lead to unnecessary and harmful investigations and treatments. Women below the age of 25 often undergo natural and harmless changes in the cervix that screening would identify as cervical abnormalities. Despite this, cervical cancer is very rare in this age group. In most cases these abnormalities resolve themselves without any need for treatment. Research has shown if women receive unnecessary treatment, this could have an adverse effect on their future childbearing. In women under 25, therefore, this risk outweighs any benefit. Following a review, carried out by the independent Advisory Committee on Cervical Screening (ACCS) in 2009, it was agreed unanimously there should be no change in the screening age as evidence showed that earlier screening could do more harm than good causing too many young women to be treated, increasing the risk of premature births in some women. Women aged 65 and over who have had three consecutive negative results in the last 10 years are also not recommended to undergo screening. The natural history and progression of cervical cancer means it is highly unlikely that such women will go on to
develop the disease. Women aged 65 and over who have never had a test are entitled to one. Women aged 65 and over who have had a recent abnormality will continue to be followed up.
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