Cervical cancer controversy; FAQs

 

Q: What is a cervical screening and how do I go about getting one?

A: Cervical screening is a simple procedure where a doctor or nurse takes a sample of cells from a woman’s cervix to look for early changes that, if left untreated, could become cancer.

Q: Is it invasive?

A: The test involves the use of a small, specialised brush to gently remove a sample of cells from the cervix. To do this the doctor or nurse will use an instrument called a speculum to hold the vaginal walls open. The test can be uncomfortable but shouldn’t be painful.

Q: Who does it?

A: A doctor or nurse who is trained in smear taking. Then the results are taken to a cytologist – a specialist in spotting cell changes - to read.

Q: Where do I go to get one?

A: If you wish to get a test, talk to your GP or local family planning clinic.

Q: How long does it take?

A: Only a few minutes.

Q: When will I get my results?

A: Once the test is complete the brush ‘smears’ will be taken to a specialist to read the sample and check for any abnormalities. The results will then be returned to your doctor or nurse, who will then contact you about them. Results are typically available within four weeks.

Q: Can anyone get one? Do you have to be above or below a certain age?

A: The CervicalCheck programme covers women aged 25-60, but any woman can contact their GP to get a smear test.

Q: Should I get checked?

A: Cervical screening is a test for cervical cancer when a woman has no signs or symptoms. It’s life-saving because it spots changes before they develop into cancer, meaning that women can be treated earlier to stop the cancer occurring. For this reason the Irish Cancer Society would always advise women to attend their screening appointments.

If you have any signs or symptoms of cervical cancer you should immediately contact your doctor, who may then carry out advanced tests as required. Signs and symptoms include unusual vaginal bleeding (between periods, after sex or after the menopause), a vaginal discharge that may smell unpleasant, or discomfort or pain during sex or in the pelvic area.

Q: Can I be confident the test will be carried out properly?

A: Yes. The smear test is a simple, harmless procedure carried out by trained professionals. Much of this week’s concerns stem from the reading of the test results. While those reading the results are experts in their field, they are only human, and reading so many results means that in a small proportion of cases an abnormality can be missed.

Q: I heard the minister talking about a free test. Who is entitled to one? And why? Who isn’t entitled to one? Why? How do I avail of it?

A: The CervicalCheck screening programme is free to all women in Ireland aged 25-60. This week the Minister said that any woman who wants to have a cervical smear test will be entitled to have one free of charge at a GP surgery or family planning clinic.

Even if you don’t know whether you should get a re-test, you should talk to your doctor or family planning clinic.

The HSE has told GPs they will be paid for the extra test or a consultation with a patient who does not opt for additional screening.

Q: Is there an option to get a test privately or publicly?

A: You can get a test privately, however there may be a charge. Public tests through CervicalCheck are free.

Q: If I go privately, is the test covered by my health insurance?

A: This will differ by insurance provider and policy and should be checked with them beforehand.

Q: Everyone is talking about an American lab. Will my test still get sent there?

A: CervicalCheck tests are sent to one of three laboratories. Two of them are in Ireland - MedLab Pathology Ltd, Dublin and the Coombe Women and Infant’s Hospital, Dublin. One of them is in the US - Quest Diagnostics Inc, Teterboro, New Jersey, USA.

They are certified by the relevant national authorities. Two experts examine every test.

A US lab is used because there are not enough quality-assured labs available in Ireland to meet the need of the screening programme. The HSE’s SIMT is assured that these services are being provided to the required standard and should continue to be used.

Q: I heard there are new HPV tests. Is this a good thing? What’s the difference with the old one?

A: HPV DNA Testing is set to be introduced in the autumn. This test was advised by HIQA last year. Their Health Technology Assessment found that changing to primary HPV testing would reduce the number of screenings each woman has in her lifetime, while providing better accuracy in detecting precancerous abnormalities and early stage invasive cervical cancer. 

Women would experience no change in how the cervical screening sample is collected. It would lead to 20% more pre-cancers detected, 30% more cancers and mean screening moving from every 3 years to every 5 years for women who’ve had the HPV vaccine, which prevents 7 in 10 cases of cervical cancer.

Date Last Reviewed: 
Monday, March 26, 2018