What's the cervix?

The cervix is part of the uterus (womb) and is where the vagina and the uterus meet, it is sometimes called the 'neck' of the womb.

What is cervical cancer?

Cells in this part of the uterus can undergo changes and cancer of the cervix can develop. This is quite a common cancer and is the second most common kind in women under 35. Fortunately, there are now many measures which can be taken to avoid the development of cervical cancer. These involve either preventing the cells in the uterus undergoing any changes or detecting these changes very early and treating them before the cancer can develop.

Most cases of cervical cancer are caused by a virus called human papilloma virus (HPV). This virus is spread during sex - vaginal, anal or oral. Using condoms is a good way to lower the chance of HPV infection but it doesn't get rid of it entirely.  HPV infection is very common and most people get rid of it themselves through their own immune systems; infection does not mean that women will definitely develop cervical cancer it just increases the risk. HPV damages the cells in the cervix and causes the cell changes that can be detected by a smear test. A vaccine against HPV has been developed and is currently being given to all girls aged 12-13 (school year eight).

What are the risk factors?

• Pain or discomfort during sex

• Pain in the lower back or pelvis

• A smelly or unusual discharge from your vagina

• Abnromal bleeding i.e after sex or inbetween periods

All of these symptoms have other causes besides cervical cancer but if you are experiencing any of them it is really important to see your GP as soon as you can. The symptoms of cervical cancer often develop very late in the progress of the disease and changes can be picked up by smear tests and treated long before any symptoms develop so it is really important to attend smear tests even if you have no symptoms.

Risk Factors

Several factors have been found which increase the likelihood of developing cervical cancer, these include:

• People who have sex for the first time at a young age

• Having lots of sexual partners

• Smokers

• Having a child before the age of 17

• Having more than 3 children

• Having a weak immune system

• Not having regular smear tests

What is a Smear Test?

Cervical cancer is a disease which takes years to develop. Before the cancer develops the cells of the cervix go through changes and a precancer stage called CIN or cervical intraepithelial neoplasia. A cervical screening test detects this precancer stage. During a smear test a small sample of cells are taken from the cervix  and are examined to detect any cell changes. The test is performed by first undressing from the waist down and lying comfortably on a coach. A nurse or doctor inserts an instrument called a speculum into the vagina which gently holds the walls of the vagina open so the cervix can be seen. A small brush-like instrument is inserted and some cells are wiped off the surface of the cervix. These are then sent off the the laboratory to be looked at under a microscope. The whole thing normally takes about five minutes and may be a little uncomfortable but isn't usually painful. Most women are invited for their first smear test when they are twenty-five and are usually invited back every three years. If any precancerous changes are found from your smear tests these can normally be easily treated and then cervical cancer will not develop. If you are below twenty-five and you feel you would like a smear test then this is something you should discuss with your GP.

What is the vaccine?

The HPV vaccine protects against two strains of HPV, these are 16 and 18, these two strains are the cause of over 70% of cervical cancer cases. This vaccination is currently being offered to all school age girls and consists of three injections over six months. These injections are being given through schools, though girls who are slightly older, 16-18, can obtain the vaccination through their GP. For more details on this scheme see

www.hpv123.org

The vaccine has gone though very rigorous tests to make sure it is safe and there are very few side effects. The protection from the vaccine lasts for at least six years. It only protects against some kinds of HPV though, and does not protect against any other STI's or pregnancy. If you are over eighteen and feel that you would like to have the vaccination this is a matter to discuss with your GP, you should be aware that at present you may have to pay to have the vaccine privately.