Gynaecologist won't let his daughters wait for smears

An expert in gynaecology has said he won't let his daughters wait until they are 25 before they can have a smear test.

Consultant Gynaecologist Paul Carter has seen many cases of cervical cancer that could have been prevented had they been detected earlier in a cervical screening:

"I have three daughters and I certainly won't leave it to 25 for them to have their first smear. Fewer than 60 women develop cancer under the age of 25 each year, but it is still too many.

"Many doctors – myself included – believe that the starting age for smears in England should be lowered, as teenagers become sexually active earlier."

Read the full article from the Daily Mail here.

Dr Hilary says money IS a factor

TV's Dr Hilary Jones said on live TV this morning that women under 25 are not screened due to money.

ITV's Daybreak had a feature about the new home testing kit for certain strands of the HPV virus that can lead to cervical cancer, and Dr Hilary was asked why under 25s weren't routinely screened any more:

"The point is that cervical cancer in someone aged under 25 is really very very rare - thankfully. 

"If we were to roll out the screening programme to all women under that age we're talking millions and millions of pounds, and there has to be a cut off point with screening where you say 'Is that money well spent? Should we be screening at a younger age?' 

"In some countries they do, in the UK the government have decided that it's not cost effective to do it. Now that's a debate to be had, but we would pick up very few women under that age."

You can watch the video and check out Daybreak's Cervical Cancer information page here.

Smear tests being binned, reveal Newsnight

Cervical screenings for under 25s are being binned before being tested for abnormal and pre-cancerous cells.

Women under the age of 25 are not able to have cervical screenings due to legislation imposed by the Department of Health in 2003. But there are many young women at a higher risk of cervical cancer whose GP's feel it necessary for them to be tested.

ITV's Dr Chris Steele has found out, though, that once the sample reaches the laboratory the government instructions are to bin those from women who were too young.

More than 700 rests sent to labs in 2010 for analysis were ignored.

Dr Chris took the story to BBC's Newsnight who investigated the scandal.

Watch Newsnight's video report here

Metro Radio news also covered the story, as did People news.

What do you think?

Screening attendance has dropped again

Cervical screenings are a proven way to prevent cervical cancer but hundreds of thousands of women ignore their invitations each year.
The publicity surrounding Jade Goody's illness and death in 2009 persuaded more than 300,000 more women to go to their screening that year.

But this year the number of women attending dropped again.

The Details

From 2002 to 2008:

• The percentage of women aged 25 to 49 who had been screened in the last three years fell from 71.7% to 69.3%
• In women under 35 the percentage screened dropped most dramatically from 68% to just 63%
  

Between 2008 and 2009:

• The number of women of all ages having cervical screening increased to 3.7 million from 3.4 million the year before - an increase of 10.5% (around 353,000 people)
• The three yearly coverage in women aged 25 to 49 years old reached 72.5 per cent
• The five year coverage of women aged 25 to 64 was 78.9 per cent
• The majority of this increase was in women aged 25 to 49
  

2011:

• National reports say that the number of women attending has dropped again
  

Here are some links to recent news articles to show you how important it is to go to your screening

Female First says 20% Of UK women still don't attend smear tests

The Telegraph talks about women 'making excuses' to avoid cervical cancer smear tests

This Is Leicestershire says 1,500 fewer women attended this year in their area

Net Doctor say nearly two-fifths of women they polled said they had missed or delayed appointments because it was difficult to get out of work, while 35% of those who didn't go said they'd be more likely to if GP surgeries had more flexible opening times

Scotland TV reports that 1 in 5 women in Scotland are not going either this year

Cancer Research found that older women are too embarrassed to go for smear tests, and fear pain, while younger women say they are too busy

Attending your screening is the most effective way of preventing cervical cancer, and the majority of those who do develop the disease had not attended their smear tests or follow ups, like Jade Goody.

Interview with TV's Dr Chris Steele

Dr Chris Steele has been at the forefront of many medical-related campaigns, not least of which is the campaign to get the age of cervical screenings lowered.


He's a celebrity GP who's been the 'resident' doctor of ITV's This Morning since 1988 and was awarded with an MBE in 2008.

He says his privileged position means he can make a difference and this means a lot to him.

The decision made in 2003 to lower the age of screenings angered him and he's been fighting ever since to change it back.

Dr Chris' campaign links:

• Campaign page and video
• The Twitition - a petition on Twitter
• Facebook Discussion

We met up with Dr Chris to chat about his feelings about the age of cervical screenings

Listen below for the full interview clips.


*Click 'Read More' on the left or HERE to listen*

Screening ages around the globe

UK
* In 2003 the age of first invitation to cervical screening in England went up from 20 up to 25
* In January 2011 Northern Ireland followed suit
* The first invite in Scotland and Wales is age 20


Europe
* Countries that screen at an older age include Bulgaria (31+), and Estonia, Finland, and Lithuania (30+)
* Countries who also screen from age 25 like England include Belgium, Croatia, Czech Republic, Hungary, Italy, Ireland, Norway, Poland, Portugal, Romania and Serbia
* Screenings from age 20 can be found in France, Germany, Greece, Iceland, Latvia, and Slovenia
* Denmark screen from age 23
* The countries who screen at the youngest age are Luxembourg (16+), and Turkey and Austria (18+)


Elsewhere
* In America girls are able to have a smear test from the moment they are sexually active - from the sexual debut, as they say
* And in Australia their government Screening Programme starts from age 18

Cervical Screenings - The Basics

What are cervical screenings for?
The most common misunderstanding about cervical screenings is that cervical screenings test for cancer, but in actual fact they test for early changes in the cells in the cervix that could possible lead to cancer (but don't always).

Screenings do not test for sexually transmitted infections.

Why are they important?
All women who have ever had sex could be at risk of getting cervical cancer.

The early stages of cervical cancer have no symptoms, and smear tests are the only way to detect changes.

Since the NHS cervical screening programme was introduced in the 80s the number of people being diagnosed with cervical cancer has more than halved.

It is the absolute best way to prevent cervical cancer, and many who die from cervical cancer are those who have not had a smear test or attended their invitations. Jade Goody worked so hard to promote the importance of cervical screenings at the end of her life for that very reason - she did not go to hers and as a result she lost her life.

What happens?
Cells are collected from the cervix using a small brush-like object called a speculum which is gently brushed along the inside of your cervix. That is then sent to a laboratory where they are tested for anything unusual.

It only takes a few minutes and no drugs are used, and they are usually done by a health worker, nurse or GP. You won't have to undress completely, only from the bottom down, and if you're wearing a loose skirt you can just pull that up.

The nurse will make sure you are comfortable and okay the whole time, and although some people are nervous or embarrassed about the procedure, the benefits really outweigh any of that.

Then what?
If anything unusual is found further tests will be done to see if treatment is needed.

Treatment is not always needed though, and one option could be to come back for another smear in a few months time to check progress - sometimes the changes just sort themselves out.

Sometimes the samples are difficult to interpret, for example if there is too much mucus, in which case the GP will ask you to have another smear test.

How often should I be tested?
From age 25 to 49 you will receive an invitation for a screening every 3 years.

From age 50 to 64 you will be invited every 5 years.

If one of your tests is returned with abnormal results you may be tested more frequently to keep an eye on things.

This information is only very basic so please read this NHS Guide on Cervical Screening Facts for all your questions answered in a really straightforward and helpful way.

Facts and Figures

Cervical Cancer

* In the UK cervical cancer is the 2nd most common cancer in women under 35 after breast cancer


* Almost 1,000 women die of cervical cancer each year


* Around 7 to 10 of those are under 25


* 7% of cervical cancer deaths each year are in women under 35


* Around 2,800 women a year are diagnosed with cervical cancer


* And around 60 girls under 25 are diagnosed each year

Cervical Screenings

* Up to 4,500 lives are saved every year from cervical screenings


* 4 million women are invited for a screening each year


* 1 in 5 women never go their screenings


* 1 in 20 cervical screenings will show changes in cells, but most of these will not lead to cancer


* Early detection and treatment can prevent up to 75% of cervical cancers from developing


* Not going to screenings is the biggest risk factor for getting cervical cancer


* Cervical cancer rates have halved since the 1980s due to the screening programme

Human Papillomavirus (HPV)

* 99.7% of cervical cancer cases are caused by persistent infection of HPV, transmitted through sex.


* Up to 80% of people will be infected with HPV in their lifetime (through skin to skin contact in the genital area), but for most women this will never lead to cervical cancer.


* The HPV vaccine can prevent up to 70% of cervical cancers

Why was the age for screenings raised?

In 2003 the Department of Health made a decision to raise the age for first cervical screening from 20 up to age 25.

This decision was made from recommendations by:
- The International Agency for Research on Cancer, an agency of the World Health Organisation that coordinates and conducts research into cancer
- Cancer Research UK
- The independent Advisory Committee on Cervical Screening

Research found that screening younger women did more harm than good, and the Committee concluded that age 25 was the tipping point at which the benefits outweighed the risks.

In 2009 public demand forced the Advisory Committee to review their decision, but they concluded that no changes were to be made.

Here are the main reasons they give for raising the age:

1. Cervical screenings could lead to unnecessary treatment

• Younger women often undergo natural and harmless changes in cells in the cervix
• These cell changes would show up on a smear test as an abnormal result
• Most of these changes are harmless and are likely to correct themselves over time
• This higher degree of changes means that 1 in 3 cervical screenings will find abnormal results, compared to 1 in 14 of older women, meaning there are many false positives
• This will lead to unnecessary treatment

2. This treatment is potentially harmful

• The research suggested that such treatment could affect pregnancy in women, for example with a possibility of causing miscarriages, still births, premature labour or problems in labour 
• The first point of call with an abnormal smear is merely to investigate further
• One option is to observe changes over a number of months, which merely requires follow-up smears to check the development - so not all abnormal results will lead to treatment
• Another option is to remove a portion of the cells in a minor operation for further examination, which may or may not then require treatment
• Treatment can be as simple as removing the abnormal cells from the cervix
• ...but it can also mean a much rarer and more invasive treatment of cutting part of the cervix away, leaving it shortened and weakened. It is this treatment that the research suggested had a possibility of affecting childbirth
• Therefore in under 25s they concluded that the risk outweighs the benefit

3. It causes unnecessary worry and stress

• Getting an abnormal result, for many women, causes a degree of worry and stress
• Because of the high level of false positives in younger women for cell changes that are mostly normal and harmless, these women are put under stress about their abnormal result unnecessarily

4. Relatively few cervical cancers are detected in under 25s - it is very rare