Saturday 10 December 2016

Register for a free smear; and red spots on skin

Nina Byrnes

Published 04/08/2015 | 02:30

Register with Cervicalcheck for a free smear test. Photo: Getty Images
Register with Cervicalcheck for a free smear test. Photo: Getty Images

Advice from our GP about a booking a smear test and Campbell de Morgan spots.

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Question: I'm thinking about booking a smear test. I am not in a relationship and the moment and actually haven't been in years. Do I really need to have one? Where can I book one?

Dr Nina replies: Cervical cancer (cancer of the neck of the womb) is the second-most common female cancer in Europe and about 200 cases are diagnosed each year in Ireland.

During a smear test a brushing of cells is taken from the neck of the womb. These can then be examined under microscope to check for abnormalities. It is recommend to have a smear test every three years from the age of 25 to 45 and every five years from the age of 45 to 60. The national cervical cancer screening programme Cervicalcheck makes these smears available free of charge to all those in the screening age group.

In order to avail of a free smear you must register with Cervicalcheck. Once registered you can attend any registered practitioner for a free smear test. Most GP practices are registered providers of free smears. You do not need to attend a hospital or specialist clinic for this test. Neither do you need to be a registered patient of the practice to avail of the free smear test.

If you have ever been sexually active you should have regular smears, even if your last relationship was many years ago, regular smears are important.

Women who have sex with women should also be screened. If you have never been sexually active the risk of developing cervical cancer is low but you may still wish to avail of the screening.

The best time to have a smear test is midway in your menstrual cycle. It may however be difficult to time this. A smear can be done anytime except during your period. The presence of blood in the smear makes analysing the sample more difficult.

Menopausal women under the age of 60 still need smear tests. The lack of oestrogen during menopause can cause some vaginal dryness which can make smears more difficult to read. If this is the case your GP may prescribe local oestrogen treatment before repeating the test.

Smear tests should not be painful. If you are anxious about the test or have had difficulty having a smear in the past talk to your GP they can reassure you and help ensure that the smear is a less stressful procedure next time.

For more information on the nation screening programme see cervicalcheck.ie

Question: I have a lot of small red spots on my body. They are mainly on my stomach and back. These only appeared over the last 10 years. I am 50. Will I get more of these and do I need to worry about them? .

Dr Nina replies: The spots you refer to are commonly known as Campbell de Morgan spots. They are named after a 19th-century English surgeon who first described them. They tend to appear after the age of 40 but occur equally in men and women across all races.

They are extremely common and thought to appear in 75pc of those over the age of 70.They can occur anywhere on the body but most commonly occur on the trunk. The lesions are composed of a collection of small dilated capillaries or venues which are the smallest blood vessels in the body. They are a type of angioma.

The appearance of Campbell de Morgan spots can cause some alarm but they are nearly always harmless and benign. These spots are normally one to three millimetres in diameter, and do not blanch or disappear when you press on them. They don't normally cause any symptoms such as irritation or itch. The colour is normally cherry red but they may appear blue or purple also.

Another common cause of small red spots on the trunk is spider naevi. These are also a form of angioma or collection of blood vessels but they have a red centre with little capillary spider-like legs growing out from the centre. When you press on these they disappear and then refill from the centre out when you release the skin again. Spider naevi can increase in pregnancy and may also occur more commonly in those with liver disease.

More rarely a collection of blood vessels or angioma may occur on the lip. They most commonly appear bluish or purple here.

Angiomas do not require any treatment. Rarely more unusual spots may be removed to confirm the diagnosis. Those who find them cosmetically unacceptable may seek treatment. Cryotherapy involves freezing the tissue to a very low temperature. Laser is another treatment option.

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