Have you noticed anything different about your recent smear results? This may not be a question you get asked very often I realize, but smear testing has changed and it has certainly caused some confusion amongst many of my patients. In around 2008 the powers that be started introducing ‘HPV testing’ into the cervical smear programme, and it was found to be so successful that it has been rolled out all across the country.
You may be vaguely aware of the link between cervical cancer and the HPV virus. HPV or Human Papilloma Virus is a family of bugs transmitted by sexual intercourse, and it is incredibly common. It’s thought that up to 80% of sexually active people will have had HPV at some point. There are over 100 different types of HPV, and the most benign strains come and go leaving you none the wiser. Other types cause genital warts. The most worrying group however cause more serious health problems, and are thought to be responsible for around 99% of all cases of cervical cancer. Although initially HPV doesn’t usually cause symptoms, longer term the virus can affect the cells of the cervix causing them to become cancerous.
You may know adolescent girls who have undergone the HPV vaccination programme at school, which protects them against these high-risk strains of HPV – a fantastic and effective breakthrough in reducing overall cervical cancer rates.
So where does this leave us and our smears? Well, previously cervical screening just looked for any abnormal changes in the cells of the cervix. Results would come back in the following categories: normal, inadequate sample, borderline cell changes, mild cell changes, moderate cell changes or severe cell changes. If you were found to have moderate or severe changes you did (and still will be) automatically referred to hospital for a more detailed internal examination called a colposcopy. The new screening programme affects results in the borderline or mild category.
Previously women in this group were also often referred directly to see a gynaecologist for colposcopy. However with the advent of HPV testing any samples in this category are now tested for the high risks strains of the virus. If you are negative for the virus there is a very high chance your abnormal smear will go back to normal on its own accord, and therefore more invasive examinations are not required. If however you test positive for HPV then there is a higher risk of more permanent cell changes, so a gynaecology appointment is recommended.
This new testing is also having an impact on women who are being regularly seen by the hospital for monitoring, having had previous abnormal smear tests. If you are now found to be HPV negative, your risk of long term problems is reduced and you may find you are now able to go back to normal routine smear testing at your GP surgery.
The bottom line is the new programme is more accurately targeting women who are at higher risk of developing more serious cervical problems, and avoiding doing excessive investigations on women who are lower risk.
Above all don’t forget to keep up to date with your smear tests – it could save your life!
More more information see the NHS Cervical Screening site.