Cervical Cytology

The most important risk factor for cervical cancer is infection with some strains of the human papilloma virus (HPV, which can sometimes be called wart virus infection).  High risk strains of HPV are found in 99% of cervical cancers. HPV is a very common sexually transmitted virus which most people contract shortly after becoming sexually active. In 9 out of 10 women, the virus is cleared naturally by the body’s immune system within a year.

Tests are available to detect this infection but at present they are not part of the cervical screening programme. Trials are currently taking place in England to assess the usefulness of HPV testing.

A vaccine is also now available to prevent infection with the most common high risk types of HPV. In the UK, from Autumn 2008, the HPV vaccine is being offered to girls aged 12-13 years as part of a national vaccination programme. The vaccine will made available through most schools and for older teenage girls through their general practitioners .  It is given in three doses over a period of six months and should ideally be given before a girl becomes sexually active.  However, even if you have been vaccinated, it is important to continue to accept your invitation for screening.

Some risk factors such as the age at which sexual intercourse begins (the earlier, the higher the risk) and multiple sexual partners, contribute an increased risk of having the virus. Other factors are infrequent cervical screening, a history of abnormal cervical cytology or treatment for cervical abnormalities, using the oral contraceptive pill and cigarette smoking.  Women whose immune systems are less active are also at increased risk and women who are HIV positive are recommended to be screened annually.

In most of these circumstances, with the exception of previous treatment for high grade cervical abnormalities, regular 3-5 yearly screening is sufficient protection from cervical cancer.

Progression from HPV infection through cervical abnormalities to cervical cancer is slow, and may take many years. It is because of this, that regular cervical screening offers the best opportunity to prevent cancer from developing by allowing the detection and removal of abnormal tissue.  Regular tests may also detect the cancer early if it does develop.

Minimally invasive surgery of the cervix, also known as LLETZ, which can be carried out in an outpatients clinic to remove abnormal areas of the cervix or a very early stage cancer is the standard treatment.  In more advanced cervical cancers, a hysterectomy (removal of the womb) may be performed.  New surgical techniques are being developed to preserve fertility when cervical cancer affects young women. In some circumstances, where the cancer is more advanced, radiotherapy or chemotherapy may be required and, additional surgery may be needed.