Monday 16 September 2019

Cervical Checks: what should you do next?

Among the thousands of women worried about the cervical cancer crisis are two cohorts, those who have been tested and those who have not. Their concerns vary but are valid.

While they might ask about the accuracy of previous test results or question if they should even consider getting a test, all the authoritative voices are united with one clear message: Get checked.

"It's life saving," says Irish Cancer Society cancer support manager Joan Kelly. "It spots changes before they develop into cancer. "It means women can be treated earlier to stop the cancer occurring."

The HSE concedes a small number of tests can lead to a missed reading but, at a rate of 0.8pc, an abnormality can be missed in fewer than one of every 100 cases.

Cervical screening tests women for changes in the cells of the cervix using a smear test. It is described as uncomfortable rather than painful by Dr Shirley McQuade, medical director at the Dublin Well Woman Centre.

Test results can take four to six weeks to come back from a lab and Dr McQuade has warned that these waiting times may increase in the coming weeks and months as more women seek to get checked amid ongoing concern.

She insists women can be confident of tests being carried out properly. "The quality of samples is monitored and anyone who is below the normal standard is notified and required to have extra training if they wish to continue to take smear tests," she said.

She adds women who have previously undergone the test and got normal results are unlikely to encounter a problem.

However, these women can get tested again. Last week, Health Minister Simon Harris made a move to reassure the public by guaranteeing that any woman aged between 25 and 60 who wants to have a cervical smear test will be entitled to one free of charge at a GP surgery or family planning clinic. More than 4,500 doctors and nurses are registered with CervicalCheck to provide free tests under the scheme, so finding a local practice with the service should not be too difficult.

Private gynaecologists and clinics also offer the service but can cost in the region of €85 to €100. These are generally not covered by a private health insurer.

"Anyone who has had a test in the screening programme is entitled to have a repeat test if they are worried about the accuracy of their result," says Dr McQuade.

"However, if your last test was less than three months ago you need to wait until those three months have passed before you can go again because it takes that length of time for the cells to regenerate on the cervix."

The Irish Cancer Society is urging anyone with concerns to take another test.

It insists women who have received letters from CervicalCheck in recent days should not be concerned. It met with the minister last week and asked him to contact women of screening age to highlight the value of the service.

Ms Kelly said: "We also stressed to the minister that everything possible must be done to help all the women affected by testing errors and their families on a one-to-one basis."

If you've already undergone the test

Ms Kelly said it is understandable that women who have previously had a test will be concerned.

"There have been a lot of mixed messages for women over the last week," she says. "Cervical screening is not perfect and, due to human or technical errors, mistakes may occur but that should be in a tiny fraction of cases."

She says the best way to ease concerns of those women who have previously had a test is to undergo another exam.

The HSE said a letter sent from CervicalCheck following your last smear test will indicate when the next test is due. Anyone who is unsure is asked to consult their GP.

"The best course of action is to have another smear test," said Ms Kelly.

"This can be done by going to your GP or family planning clinic and requesting a free smear test. Talk to your doctor or nurse. They should be able to make the request on your behalf."

If you have never undergone the test

International best practice recommends a cervical screen programme should target women aged between 25 and 30 years old to 60 and 65 years old. The HSE says this is why CervicalCheck is available for free to women between 25 and 60 years. A smear test is not a test for cancer but screening is seen as the best preventative measure because it can facilitate early detection.

"The aim is to find and treat mild cell changes before they progress to cancer," says Dr McQuade. "We know that cell change happens slowly so having regular tests every three years should pick up any changes."

Doctors are sent the result of the smear by a laboratory. CervicalCheck writes to the woman advising her when the result is available and of any steps that need to be taken within the programme.

women Aged 60 and over

Women aged 60 and over are not routinely invited for a smear test by CervicalCheck. The Irish Cancer Society advises anyone in this demographic who has never had a test to consult their doctor about the possible need for a free test. Dr McQuade says circumstances are somewhat different for over-60s who have previously had the tests.

"If you have had a number of smear tests in the past that were all normal then you do not need to have any further tests. If you have symptoms such as pain, bleeding or discharge then you should see your doctor, who will investigate and possibly send you for a gynaecology opinion."

Sunday Independent

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