Regular Screening
News of Labour MP Kiri Allan’s cervical cancer diagnosis has highlighted the need for women to have regular cervical smears and report any unusual bleeding or discomfort to their doctor. Oxford Women’s Health gynaecologist Richard Dover explains the importance of regular screening, attending follow-up appointments, and upcoming changes to cervical screening.
aving a three-yearly smear is likened by many women to going to the dentist or having a mammogram – far from a favourite activity but one of life’s necessities to make sure they stay fit and healthy for themselves and their whānau.
In New Zealand, anyone with a cervix or vagina who has ever been sexually active should have regular cervical screening from the time they turn 25 until they are 70. A cervical smear involves a small sample being taken to detect any unusual cells. If something out of the ordinary is discovered, the person will be referred for colposcopy, a procedure to closely examine the cervix and check for any abnormal changes.
The prospect of having colposcopy makes most people feel a little uneasy, but staff performing the procedure are trained to make it as comfortable and quick as possible. The majority of people referred for colposcopy turn up for their appointments, but I am regularly troubled by those who receive a referral and decide not to attend. If you are booked for colposcopy, it means things aren’t normal and need to be investigated to either give you peace of mind that all is well or ensure that you receive treatment for whatever else is found. These appointments literally save lives.
Unlike many cancers, we know exactly what causes most cervical cancers – Human papillomavirus (HPV). In New Zealand, young women and men aged nine to 26 years are able to be vaccinated against HPV to help prevent them from getting cervical cancer or passing on the virus.
With this in mind, cervical cancer screening is about to change in New Zealand, in line with many other countries. In Australia, for example, the National Cervical Screening Programme has changed from three-yearly cervical screening to an HPV test every five years. If the test finds that someone could be at risk of cervical cancer, they receive further investigation. This type of five-yearly HPV testing has been found to be more effective than three-yearly cervical screening programmes. Over time it is also hoped that women will be able to carry out the tests at home, which should make it even more effective and inclusive.
While we wait for the start of this new way of screening in New Zealand, it is important women continue to have regular cervical smears. Sadly, most women who are diagnosed with cervical cancer have had smears but not frequently enough to pick up cancerous changes in the early stages when it can be easily treated.
Similarly everyone who is eligible for HPV vaccination should make an appointment with their General Practice to be vaccinated. Just remember that even if you are vaccinated you still need to take part in regular screening or testing.
Oxford Women’s Health Gynaecologist Richard Dover specialises in hysteroscopic and advanced laparoscopic surgery; and investigating and treating endometriosis, menstrual problems and pelvic pain. For more information, visit oxfordwomenshealth.co.nz
