Most women know the importance of regular Smear Tests to look for the early signs of Cervical Cancer.  Guidelines in the UK have changed over recent years for NHS patients, and in some cases differ from guidelines in the USA and Australia.  The Center for Disease Control (CDC) is the US Government organisation for issuing guidelines there.  We thought it would be interesting to look at the two countries recommendations.

Age of First Screen

This is one of the largest areas of debate in the UK.  It used to be (in the 1990s) that the recommendation was that the NHS screen everyone a year after they became sexually active.  Now the minimum age is 25 for an NHS test.  You can choose to have a private test in the UK with Better2Know at any age.  The CDC guidelines suggest a minimum age of 21 (but never below this age, regardless of how sexually active they are).  In Australia the suggested age is 18.

So is the difference all to do with cost pressures in the NHS?  We have all seen stories in the UK media of young women sadly having cervical cancer in their teens, and their requests for testing ignored by their doctors until the cancer was more advanced.  No doctor wants this.  The cervix is still developing and changing in young women.  There have been reports in The Guardian that testing teenagers in some cases can lead to a wrong test results causing years of worry about a condition that does not exist.  However some people find that it is Better2Know the results of their test and that is where we can help you to get tested, whatever your age.

 

What to test for?

In case you are thinking “isn’t that obvious – it’s a smear test” let’s have a look.  A PAP Smear (usually called a smear test) takes a sample of cells from your cervix and looks at them under a microscope for evidence of cancer or pre-cancerous growth.  It is looking for signs that you have or may go on to have cervical cancer.  This is the current test available on the NHS in the UK.  It does not end here.

Best Practice guidelines in the UK suggest having an HPV test at the same time.  This is being trialed in some areas of the UK by the NHS.  An HPV test looks for the Human Papilloma Virus (HPV).  There are over 100 types of the HPV virus.  Around 40 of them are sexually transmitted, and 14 of these are said to be High Risk (HR), which means that if you have an infection with this virus, you are at higher risk of developing cervical cancer.  An HPV infection is the lead cause of between 70% to 90% of cervical cancers.

Better2Know suggests that women have an HPV test at the same time as a Smear Test.  We can do the test on the same sample – so this means only one “collection”.  If you only have an HPV test with a cervical sample, and it comes back with a viral type detected.  You do have to wait three months before you can have a Smear Test to look for abnormal cells, to allow the cells to grow back.

The Better2Know HPV test looks for the 14 High Risk types typically the NHS looks for where they offer the test, and 6 Low Risk types, which are the most common causes of Genital Warts.  Genital Warts are caused by a Low Risk HPV type.  So having genital warts does not mean that you will have cervical cancer.  You can however, be infected with many different types of the virus.

In the US, HPV testing is recommended for all women over the age of 30, and it can be used to extend the interval to the next test to five years.  There is also a move in the US to start offering HPV testing as the preferred method – above a Smear Test.  The drawback in this, is that if there are HPV viral types detected, then a smear test cannot be offered straight away.

In Australia, Smear tests continue to be used as the main diagnosis test.

 

How often to get tested

On this everyone agrees that if you continue to have a normal smear test, a test every three years is the right interval.

If you have an abnormal smear, then this really depends on what happens at the further investigation on this, but more frequent smear testing, and HPV Testing (in Australia) should feature in your health plan.

 

More questions

If you have any more questions about PAP Smear Tests, HPV, Cervical Cancer and Abnormal Smear tests.  Please call us on the number above, and we will be happy to help you.

 

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