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Smear tests are so important for women, but why do we need to have them? Andy Nordin, a subspecialist gynaecological oncologist, explains why they are so important
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Andy Nordin, subspecialist gynaecological oncologist specialising in women with cancer, tells us why smear tests are so important.

Andy says: 'People usually talk about smear tests as a cervical cancer smear test when it's actually a cervical pre-cancer smear test. Women who are referred to hospital because of an abnormal test, in the very large majority don't have cancer, they have pre-cancer and they can have a small procedure done in the clinic under local anaesthetic which will prevent cancer forming.'

Cervical cancer

'It's one of the few cancers where we can detect the pre-cancer changes, treat the pre-cancer and stop cancer from forming.

'Cervical cancer develops as a process through a pre-cancer stage, which is called CIN. And it's caused by an infection with a particular virus called Human Papilloma Virus (HPV) sometimes called the 'wart virus'. The infection with HPV is extremely common.

'They say by the age of 50, 80% of women will have been exposed to the wart virus. And there are certain types of the wart virus, which predispose to developing precancer and cancer of the cervix.

'The interesting thing about those high-risk HPV infections is that they're very, very common and at the age of 20, something like 1 in 3 women will have an infection and at the age of 25, it's about 1in 4. And by the age 35 it's about one in 8. 

'It's very common to get the infection but most women, and men, for that matter, clear the infection themselves and it goes away.

'Women who are at risk of developing cervical cancer are women who have that infection and their immune system doesn't clear it. And so it stays in the skin and the cervix and that's how the pre-cancer changes start to develop.'

Cervical screening programme

'The cervical screening programme, where women go along and have the smear test done at their doctor's, is designed to pick up those pre-cancer changes, so we can treat ladies in our colposcopy clinics to stop cancer from forming.

'About 95% of women who have high-grade, pre-cancer changes treated, find that their smears go back to normal.

'If the virus goes away, further problems are unlikely but it's important to stay within the screening programme and after a pre-cancer treatment, women have a smear every year for 10 years before they go back into routine 3-year screening.

'I can't emphasize strongly enough how important going along for your regular cervical smear test is.

'Cervical cancer really is a preventable cancer and we've seen a fantastic reduction in the incidents, the number of cases of cervical cancer occurring, and also the death rate, the mortality, from cervical cancer, since the screening programme was properly established in 1988.'

Where to next 

What is cervical cancer? 

Tips for a good smear test 

Smear tests: What can I expect? 

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