It's Cervical Cancer Prevention Week. Put your questions to the experts from Jo's Cervical Cancer Trust, Friday 27 Jan, 1-2pm

[RachelMumsnet]

To mark Cervical Cancer Prevention Week, we’re running a webchat on Friday (27 Jan) lunchtime, between 1 and 2pm with Adeola Olaitan and Claire Cohen from Jo’s Cervical Cancer Trust. Please join us then, or post your questions in advance on this thread.

Every year in the UK, around 3,000 women will be diagnosed with cervical cancer. It is is the most common cancer in women aged 35 and under. Adeola Olaitan, Consultant Gynaecological Oncologist at the University College London Hospital, and Claire Cohen, Head of Information and Education at Jo’s Cervical Cancer Trust will be on-hand on Friday to answer your questions, whether you're unsure what the symptoms are, have questions about cervical screening (smear tests), are worried about your chances of contracting cervical cancer, or you've been diagnosed and want to know more about treatment and support.

Join Jo’s Cervical Cancer Trust this week for their #SmearforSmear campaign to raise awareness across social media this week. Find out how you can join in.

Hi everyone it's great to be here, and I'm looking forward to taking your questions. Be sure to have a look on the website and our helpline's available too, at 08088028000

Hello & many thanks for your question. I think that this is a misunderstanding of the statistics. Every woman who attends for cervical screening benefits. By picking up cells which cause no symptoms and are not cancer but, if undetected and untreated, could develop into cancer, lives are saved.

I hope that this clarifies

@SaucyJack

According to the data published by the NHS, an estimated 5,000 cases of cervical cancer are prevented each year for the 5,000,000 women who participate in the cervical screening programme.

So by my maths, this means that 99.9% do not benefit from attending cervical screening.

Do you think this information should be more widely publicised so that women can make their own informed decisions?

Samantha Walsh
Please allow other women to make their own fully informed decisions. You cannot lump everyone into your own experience. We are all different and have our own lives. We need the proper information to make our own intelligent decisions.

Hello. It is great to be part of this web chat. I look forward to answering your questions.
Adeola

Hi Adeola! Thank you for coming on.

If I may speak for Jack I think the point is that experts like Margaret McCartney argue that many 'abnormal' cells in fact return to normal on their own without treatment.

Therefore, women are having treatment who do not need it, and obviously this has risks, a primary one being that women who have treatment can sustain cervical damage which can risk subsequent pregnancies.

So by that logic not every woman who attends benefits.

No you are wrong. Not every woman will benefit. Screening the whole population gives benefit to the population as a whole and it decided on that basis. But at an individual level there will be some winners and some losers.

@twixxy

Hello - I would like to ask about the HPV vaccine. How does it work and how much difference will it make? Will girls who have the vaccine still need smear tests?

The HPV vaccine helps to prevent 70% of all cervical cancers, and 90% of all genital warts. By 2025, the number of women under thirty diagnosed with cervical cancer will go down by two thirds. This means, in the future, we'll see less women diagnosed with cervical cancer as a result of the vaccine.

Girls who've had the vaccine will still need to attend cervical screening when invited in the future. You could go to jostrust.org.uk for more details.

Also I have to go offline now but I would be v interested to hear what you and Claire have to say about how many women feel coerced into screening. This has been raised by many women on Mumsnet previously.

I have a question - if someone is hpv negative, and has had the same partner for 15 years, having never slept with anyone else, and with no intention of any other partners in the future - is it still possible to still get hpv in future? Thank you!

Tipsycat I agree that women have their own choice whether or not attend - that has always been the case. No-one is forcing anyone to attend. But I do feel we should be encouraged to attend. (The new letter doesn't even have the phone number to call to book an appointment included - it's been removed). Why would you risk your life by not attending?
Anyway, you can always opt-out or ignore the letters but saving 5k lives a year is substantial I think. Regarding no screening for rectal/oral cancers - if that were to become available I'd willingly attend and promote that too. I think awareness is key.

@HarrietMWelsch

Thanks to Jo's Trust for this important chat.

I was wondering, if I were to get cervical cancer in between smears, I don't actually know what the early signs and symptoms are? What can I look out for?

The symptoms of cervical cancer to look out for are any kind of abnormal vaginal bleeding in between periods, during or after sex, unusual discharge, pain during sex, and lower back pain. If you're experiencing any of these, contact your healthcare professional to discuss them. (Not all cervical cancers have symptoms, and there's a great video on our website about symptoms.)

Hello. Thank you for your detailed question. I cannot comment specifically on your case as I have not seen & examined you but I can explain some general principles. First a smear is a screening test: it does not say this is what is wrong with the cervix but what might be wrong. That is why women with abnormal smears are then referred for a colposcopy & biopsy which guides treatment. If a biopsy shows high grade disease further treatment by LLETZ or cone is needed. Occasionally this may not show any disease as it may be that the small area of disease had been removed in the biopsy.

Do ask your Drs about your particular circumstance & I wish you all the best

@BubaMarra

Hello, hope you can help me get some answers.

My whole adult life I was having annual smear tests which were all normal. Then in April 2013 it came back as ASCUS. I was 35 yo at the time and had a baby 1.5 year earlier (quick labour, cervix ruptured). Six months later I did a punch biopsy which came back as LSIL. I was told it was no big deal and to do a follow up smear test in six months, which I did and it came back as AGUS. This, to be honest, scared me immensely. Six weeks later they did another biopsy which showed HSIL. I had several colposcopies and they all showed a lesion. I also had HPV test for a number of high and low risk strains done. It came back negative for all of them. The following month (May 2014) I had cold knife conisation and histopathology test came back as all clear, no changes in cells were found whatsoever.

All of smear tests after the conisation came back normal, hopefully this is going to be the case with the next one which is due in February!

After the cone biopsy results came back as all clear I was relieved beyond belief, but at the same time I was wondering what was actually happening there. Every single test or procedure I had came back as a different thing, it was like an alphabet soup. I still think about it, I don't know what to make of it. It keeps me from moving on from this horrible episode in my life.

@MardyMary

Do you think the NHS screening levels are sufficient? As a 45 year old woman I have one every three years - but I often wonder whether it should be done more regularly. What are the recommendations in other countries?

The NHS cervical screening programme follows national guidelines on cervical screening intervals, and it is best practice to screen women under 49 every three years - and for women over 50, they will be screened every five years until 64. Across the UK, screening starts at 25.

@fleur34

I have a question - if someone is hpv negative, and has had the same partner for 15 years, having never slept with anyone else, and with no intention of any other partners in the future - is it still possible to still get hpv in future? Thank you!

Hello
The risk of acquiring HPV infection under these circumstances is low. I would however till advise regular screening as while the risk of abnormal screening is low, it is not 0%

I hope this is helpful

@Freakingoutmummy

I'm too scared to get my smear test done. I'm 32..

Hi there so sorry to hear that you're feeling worried and scared about having a smear test. There are a couple of things that you could do to make it easier. You can talk to your practice nurse in advance of your smear test appointment - your nurse will be able to show you all the equipment involved in the test and talk you through the process. If you decide to go for your smear test, you can take someone with you to support you. You might also want to ring our helpline and talk to someone about how you're feeling it's 0808 802 8000.

I have previously had a cone biopsy done approx 8 years ago, had regular smears.
My last smear showed abnormal cells, but I am told to wait the 3 years for my next smear. Is this too long?!

Thank you, that is helpful. What do you think of the argument that HPV testing gives a more reliable result as to predicting the risk of cervical cancer in future, than a smear test?

Or put another way - if your hpv result is negative but your smear shows boderline changes, which is the more reliable result?

Where I am, the above result of hpv negative, but smear with borderline changes sends you onto a 3 year recall, but it seems concerning that some mild changes are picked up and nothing is done to check on them for 3 years....?

@Alyosha

I had a smear test 2.5 years ago which showed I had no abnormal cells and no HPV. Do I need another test in 6 months or can I wait another 2.5 years? Given the evidence that women with no abnormal cells + no HPV are at a very low risk of cervical cancer.

Hi Alyosha. If you've been invited to have another test, it would be good to take up the opportunity - but it's difficult to read from your post about whether you want the test or have been invited. Could you let us know, and we'll try to respond.

I entirely agree that a lot of abnormalities can resolve without treatment. That is why women are not offered treatment just on the basis of an abnormal smear but are referred for colposcopy where the cervical abnormality is assessed and a decision made about whether treatment is required or if the abnormalities are likely to resolve without intervention.

Women who smoke may be advised to stop smoking & this may be all the is required to a allow the abnormality to resolve.

There is however a real risk of progression to cancer in some women & treatment is recommended.

I think it is a risk to avoid screening altogether. Women who have regular screening are unlikely to get cervical cancer

@JohnnyMcGrathSaysFuckOff

Hi Adeola! Thank you for coming on.

If I may speak for Jack I think the point is that experts like Margaret McCartney argue that many 'abnormal' cells in fact return to normal on their own without treatment.

Therefore, women are having treatment who do not need it, and obviously this has risks, a primary one being that women who have treatment can sustain cervical damage which can risk subsequent pregnancies.

So by that logic not every woman who attends benefits.

@Ohwoolballs

Helo, I am sure my second ever test and first since having my son nine months ago. 1)will it hurt more than the first? I had mild to painful cramps the rest of the day last time. 2)if I asked at the time of booking would it be possible to get a coil fitted at the same time to save having my legs up twice... 3)as a woman in my late twenties, could I pay to get the hpv vaccine? Would it work?

Sorry for the rushed typing, feeding baby.

@Ohwoolballs

Helo, I am sure my second ever test and first since having my son nine months ago. 1)will it hurt more than the first? I had mild to painful cramps the rest of the day last time. 2)if I asked at the time of booking would it be possible to get a coil fitted at the same time to save having my legs up twice... 3)as a woman in my late twenties, could I pay to get the hpv vaccine? Would it work?

Sorry for the rushed typing, feeding baby.

Hi there,

In answer to your first point, it's very hard to say whether your smear test will hurt more than the first, and I'm sorry to hear that you had cramps the previous time you went. The best thing to do is to speak to your practice nurse or healthcare professional, and let them know that you had some pain before your previous test - and remember, you can say 'stop' at any point during a smear test.

For your second point, please do ask your practice nurse or healthcare professional if they can fit in your call at the same time.

For your third point, about the HPV vaccine: you can pay for the vaccine privately, and you can do this via a private GP, or some high street pharmacies. The vaccine is still effective for women over 18, however it may be less effective than if you'd had it at a younger age.

"Hello & many thanks for your question. I think that this is a misunderstanding of the statistics. Every woman who attends for cervical screening benefits. By picking up cells which cause no symptoms and are not cancer but, if undetected and untreated, could develop into cancer, lives are saved."

But in 80% women who attend cervical screening, no abnormal cells are detected, and there is nothing to treat.

What do those 80% benefit medically from then?

Hi
If you are HPV negative with mild or borderline changes then your risk of progression to high grade change is very small. It is therefore safe to have screening every three years.

A negative HPV test is an accurate and reassuring assessment of risk

@fleur34

Thank you, that is helpful. What do you think of the argument that HPV testing gives a more reliable result as to predicting the risk of cervical cancer in future, than a smear test?

Or put another way - if your hpv result is negative but your smear shows boderline changes, which is the more reliable result?

Where I am, the above result of hpv negative, but smear with borderline changes sends you onto a 3 year recall, but it seems concerning that some mild changes are picked up and nothing is done to check on them for 3 years....?

Adelia. Can you comment on Dr Margaret McCartney GP decision to opt out as discussed in her book The Patient Paradox? Can you comment on the psychological harms suffered by women that is leading to women avoiding a GP or deregistered. This has been discussed in this thread and regularly features as an issue on any Mumsnet thread about screening and smear tests?

@Catcrazy008

I have previously had a cone biopsy done approx 8 years ago, had regular smears. My last smear showed abnormal cells, but I am told to wait the 3 years for my next smear. Is this too long?!

Hello
It is difficult to answer your question without knowing the full history or indeed the grade of your recent smear abnormality. I suggest you speak to your Dr & request an explanation of the reasons behind the recommendation.

@Chocolate1985

In 2014 there was a lot of publicity over a urine test alternative to the smear test but this had never been mentioned in mainstream media again . A lot of women find the process very intrusive and uncomfortable and although we are told and know that it's better to have the test surely in 2017 there should be some alternative to this test given how traumatic many women do find it especially those who have had vaginal trauma of any kind . It's also said that cervical cancer cannot develop if you have regular smears yet I know someone who always attended for hers and in between getting a normal result three years later she had stage 2 cancer . What causes this ?

Hi Chocolate1985 -- great question about urine testing. This is very much in research testing phase, and not offered as part of the NHS cervical screening programme. Hopefully in the future other methods of screening for HPV, like urine testing, will be available, and make it easier for women who've had any kind of vaginal trauma.

Cervical screening is 80-90% reliable, but, like any test, sometimes it's impossible to be 100% accurate. A screening takes a sample of cells from the surface of the cervix. Since it's only a sample, a screening does not always accurately reflect what's occurring in the whole layer of the skin, and that's important to make a diagnosis and find abnormalities.