Understanding the new screening programme and what this means for you
Consultant Gynaecologist & Gynaecological Oncologist Mr Saurabh Phadnis at London Gynaecology helps to clarify the changes and addresses concerns surrounding cervical screening. Mr Phadnis answers a range of questions from what these changes mean for women, to revealing what the possible outcomes are following a screening, plus what it means to be HPV positive and what happens next if abnormal cells are found…
What changes have been made and when did this occur?
From April 2019, Primary HPV (Human Papillomavirus) screening was implemented in UK. This is new way of examining cervical smears, where the sample is checked for abnormal cells only if HPV is detected.
Why was this introduced?
Nearly all cervical cancers are caused by HPV infection. Screening for HPV is a better method for identifying those at a higher risk of developing cervical cancer. Also this reduces the need for further test such as colposcopy.
What does this mean for women?
The actual test remains unchanged. Women still have a cervical smear. The benefit would be reduction in the number of women having unnecessary colposcopy examination.
Which means if high risk HPV is absent then chances of developing cervical cancer is extremely low. When you compare the pre-primary HPV screening era, many women were referred to colposcopy when the smear had borderline or low grade changes.
These will not be referred now on the basis of HPV negative smear and therefore reduction in colposcopy referral eventually.
What happens during a cervical screening? How long does this take?
A cervical smear test involves vaginal examination to obtain cells from the cervix using a soft brush. It usually should not take more than 2-3 minutes.
What are the possible outcomes following a screening? What happens next?
If the screening smear is HPV negative, then the cervical smear is not checked for abnormal cells as the likelihood of one developing cancer is extremely low and recommendation is to repeat the cervical smear in 3 years.
If the screening smear is HPV positive, then the cervical smear is checked for abnormal smear. If no abnormal cells are found, recommendation is to repeat smear in 12 months. If abnormal cells are found then a special test called colposcopy is recommended. Colposcopy is simply examination of the cervix in detail using a telescope and special stains. It identifies if there is a precancerous area on the cervix. A biopsy from this area may be required for diagnosis.
Following a screening I’m HPV positive. Should I be worried and what should I do?
HPV infection is very common and does not need treatment. Most HPV infections are cleared by one’s immunity in approximately 2 years. HPV infection can cause genital warts, which may need treatment or abnormal cells from the cervix, which may need further investigation like colposcopy.
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