Are You Suffering From Smear Fear?

January 24th-31st 2016 is European Cervical Cancer Prevention Week. We're taking a look at what happens during a smear and what happens next if you receive an abnormal result.

Smear test

It’s European Cervical Cancer Prevention Week all this week – 24th-31st January – so we’re shining a light on the topic on stellar.ie. You can join in on Twitter using the hashtag #sharethewisdom, comment below and tell us your experiences, and we’re kicking off with this piece, which previously appeared in an issue of STELLAR, penned by journalist Vicki Notaro, all about why we shouldn’t fear a smear.

Hands up who’s due a free smear test? Yep, my hand is up. Like many women, I paid over €120 for a smear test in 2009. Cervical cancer was in the news a lot, after the British reality TV personality Jade Goody died from the disease at only 28 years old. At 23 I was outside the 25-60 age bracket, and therefore not eligible for a free smear, but seeing somebody so larger than life like Jade struck down in her prime by this awful disease, I just had to get checked to put my mind at rest.

The results came back clear, and I put it out of my mind. So much so that I find myself now six years later not having had another one, even though I’m entitled to thanks to the government screening programme Cervical Check. It’s something that’s so easy to put off, because it just doesn’t seem that urgent or something that can happen to me, but there’s a reason a service like Cervical Check exists in Ireland – because worldwide, cervical cancer is the second most common cancer diagnosed in women under 44 after breast cancer. More than 90 Irish women lose their lives to the disease every year. And now that I know two women in their very early thirties battling the deadly killer, it seems more real and more urgent than ever.

Cause matters

Cervical cancer is unusual because we know what causes it, and it can be prevented thanks to early detection of the virus responsible, HPV. According to the Irish Family Planning Association, 99 percent of cervical cancer is “caused by persistent infection of certain high risk types of the Human Papillomavirus (HPV), which is acquired during sexual contact.”

HPV is the umbrella term for more than 100 related viruses that affect the skin and the moist membranes of the body, particularly the genitals and mouth. HPV is so common that most adults have at least one strain of it, even if you’ve only ever slept with one person. Because it’s passed by skin to skin contact, if you’ve ever had sex you should get checked – even if you’ve used a condom. However only some of the strains are high risk, so a relatively small number of women who have HPV develop cervical cancer.

Smear tests check the cervix (the neck of the womb at the back of the vagina) for abnormal cells by scraping the area. The vagina is held open with a speculum, which most women find to be the most uncomfortable part. While it’s not exactly a pleasant experience, it’s no worse or more embarrassing than a Brazilian bikini wax – and it could save your life.

Panic stations

Irene, 32 from Dublin, had never had a smear before she went last year. “It just hadn’t occured to me to get one. I’d moved house right after I turned 25, so the Cervical Check invitation letter never got to me, and it just completely slipped my mind.” However when Irene received her results, she was told that she would have to see a gyaecologist and have a colposcopy. “I did panic at the time,” she admits. “I googled abnormal smear results which was stupid, because all that did was scare me. I was nervous before the test, but the only real difference to a regular smear is that the doctor uses a big light and magnifying glass to check how many abnormal cells there are – and if they need to, they’ll remove them, often there and then.”

In Irene’s case, there was no need for a biopsy – instead, her doctor gave her a local anaesthetic so her cervix was numb, and used an electric current technique (called LLETZ) to remove the abnormal cells, allowing normal ones to grow in their place. “To be honest, I was just really glad I’d gone for the smear test and got the treatment,” explains Irene. “I go back for a check up every six to twelve months, basically more frequent smear tests, and it’s reassuring knowing they’re keeping an eye on me.”

Myth Busting

Many women have heard horror stories about not being able to carry a baby having had a colposcopy, but that’s a myth. According to Cervical Check, “any treatment has to involve a balance between removing any problem cells and minimising any possible harm. The more of your cervix that is removed the less that remains to support future pregnancies, but your colposcopist will be aware of this.” While it’s important to remember that the vast majority of smear tests come back normal or clear, and the majority of those cases with abnormal cells are resolved by treatment like LLETZ, early detection is so vital in preventing cervical cancer – and hiding from the tests or ignoring its results can have serious consequences.

However it’s understandable that the idea of even finding out that something might be wrong is terrifying for a lot of women – especially those at the lower end of the age spectrum, for whom cancer is the last thing on their minds. Natalie has just turned 26 and is petrified of her first smear. “I’ve never had a bikini wax or anything, so the thoughts of a smear really freak me out. I know it has to be done – my mum is always telling me that I’m so lucky the service is there – but I’m mortified and afraid of the results. Still, I know it’s silly, so I’m just going to suck it up and do it – better safe and prepared than sorry, right?”

Right. So I don’t know about you, but I’ve just booked in for my next smear. After all, it’s far less scary than the alternative.

For more information, see cervicalcheck.ie.

By Vicki Notaro

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