Cervical screening, HPV and cervical cancer: A mythbusting Q&A

Around 2,600 women are diagnosed with cervical cancer in England each year, and around 690 women die from the disease, which is 2 deaths every day. It is estimated that if everyone attended screening regularly, 83% of cervical cancer cases could be prevented. But what are some of the common concerns and questions that people have around screening? Mr Adam Rosenthal, Consultant Gynaecologist, explores in this mythbusting Q&A.

I had the HPV vaccine at school. Does this mean I don’t need to go for cervical smear tests?

Wrong – although the HPV vaccination prevents the majority of cervical cancers, it is still possible to contract types of HPV which the vaccine does not prevent. A minority of women infected with these types of HPV may go on to develop cervical cancer. This is much less likely if you attend for regular smears when invited for these by the National Screening Program.

My friend went for a smear test and said it was really painful. Will I find it painful?

Smears are not usually painful. Most GPs and practice nurses are very good at taking smears, and all would want you to tell them if you feel pain, so they can change what they are doing to make it more comfortable.

My cervical smear result says I have HPV, does this mean I will get cervical cancer?

No. Around 8 in 10 women will get HPV at some point in their life. The vast majority will get rid of it naturally because their immune system fights it off. A small minority don’t manage to do this and may be at risk of developing pre-cancerous changes. Stopping smoking can help the immune system get rid of the virus.

I’ve been told HPV is a sexually transmitted infection. If I test positive for it, does that mean my partner has been unfaithful?

No. It’s possible you or your partner have had HPV for years without realising it and passed it onto each other. Condoms do not completely prevent transmission of the virus from person to person as the virus can be carried on the skin of the scrotum and vulva (outside part of the vagina). It’s so easy to catch HPV that around 8 in 10 women will get it at some point. That means it’s actually normal to have HPV. It’s not catching it that’s the problem, it’s whether your immune system gets rid of it that matters. This can take months or even years, but most women do clear it eventually.

Do cervical smear tests detect all kinds of female cancer?

No, the test is designed to detect pre-cancerous changes of the cervix only. If left untreated these changes may progress to cancer, but this takes many years. Like any medical test, smears are not 100% perfect and may miss some pre-cancers. Going for a regular smear when asked to by the national screening program is the best way to avoid a missed cancer.

My smear test was negative, does that mean I can’t have cervical cancer?

No, the test is designed to detect pre-cancerous changes and may miss a cervical cancer. If you have bleeding after sex, bleeding between periods, or have an abnormal discharge (for you) from your vagina, you should see your GP, ask them to look at your cervix and ask them for a screen for sexually transmitted infections. It’s unlikely these symptoms mean you have cancer or an infection, but it’s important to be checked. Cervical cancer and infections are all very treatable, but treatment becomes harder the longer the problem goes undetected.

My friend said smear tests can detect other types of cancer like womb and ovarian cancer. Is that correct?

It’s true that very rarely cervical smear tests do pick up pre-cancer or cancer of the womb and even less frequently, cancer of the ovary. However, the vast majority of such cancers are not detected by smear tests. Regardless of your smear test result, you should see your GP if you have any of the following symptoms:

• bleeding between periods
• bleeding after sex
• bleeding after the menopause (even once)
• vaginal discharge which is unusual for you
• persistent (lasting for more than 2 weeks) bloating
• persistent abdominal, pelvic or lower back pain
• change in bowel or bladder habit (e.g. new diarrhoea, constipation or needing to pee more often/urgently)
• persistent feeling full quickly after eating meals/loss of appetite
• persistent indigestion/feeling sick
• unexplained weight loss

It’s unlikely these symptoms are due to cancer, but they could be, and therefore you must tell your doctor if you have them. Nearly all cancers are easier to treat and more likely to be cured if they are found sooner rather than later.

For more useful information about gynaecological cancers and their symptoms go to: https://eveappeal.org.uk

To find out more about Mr Adam Rosenthal, visit his web profile here.