GP Dr Manisha Kumar

Ahead of Cervical Cancer Prevention Week (23 -29 January), North West health experts are encouraging women and people with a cervix to take up the offer of cervical screening – also known as a ‘smear test’.

GP and Chief Medical Officer for NHS Greater Manchester, Dr Manisha Kumar Dr Kumar says, far from being a test for cancer, smear tests are actually designed to prevent cancer, explaining: “Screening can spot abnormal cells early so they don’t have chance to turn into cervical cancer.”

And Aysha Badat, a Practice Nurse in Bolton, points out the benefits of detecting changes early, before symptoms start.

She says: “Some women think they don’t need a smear because they have never been sexually active. I always tell them that the risk might be slightly less, but they can still get cervical cancer and should still consider the screening available on the NHS. It’s crucial for early diagnosis, for early treatment and better health outcomes”.

Cervical screening, which looks for the human papilloma virus (HPV), is offered to all women and people with a cervix aged 25 to 64, with first appointments offered shortly after their 25th birthday. Smear tests are usually carried out at the GP surgery by a female nurse.

Despite the potentially life-saving benefits of cervical screening, fewer than 7 in 10 people in the North West who were eligible for cervical screening attended their appointments in the year to June 2022.

Eligible people are also less likely to have ever attended a cervical screening appointment if they are from a Black, Asian and Minority Ethnic background, according to a study by Jo’s Trust, the UK’s leading cervical cancer charity. The same study also found there was lower awareness among Asian women that screening is a test to check cells from the cervix to find pre-cancerous abnormalities – 70% of Asian women aged 20-65 knew this compared with 91% of white women of the same age.

Cervical cancer can be found anywhere in the cervix, which is the opening between the vagina and the womb, and part of the reproductive system. Almost all cervical cancers are caused by HPV and this is what cervical screening tests for – if your cells are shown to be abnormal, it is easily treatable, without ever developing into cancer.

Symptoms of cervical cancer can include:
• pain in your lower back, between your hip bones (pelvis), or in your lower tummy
• vaginal bleeding that’s unusual for you – including bleeding during or after sex, between your periods or after the menopause, or having heavier periods than usual
• pain when intimate with a partner

However, you don’t need to be experiencing any symptoms to have a cervical screening test. Screening is about preventing cancer and stopping it in its tracks.

People are invited for routine screening every three years between the ages of 25 and 49 and then every five years from 50 to 64. If HPV is found, the sample is checked for any cell changes and these can be treated before they get a chance to turn into cervical cancer.

If people develop symptoms of cervical cancer in between smear tests, they should contact their GP.

Although boys and girls are offered an HPV vaccine in school from Year 8, it does not protect against all types of HPV, so cervical screening is still important.
Dr Kumar said: “Cervical screening is one of the best ways to protect yourself from cervical cancer. I strongly encourage all women to book their smear test as soon as they receive a letter inviting them to do so.

“I know some people feel embarrassed about having a smear test. Rest assured this is an everyday part of the job for practice nurses, they’ll just be pleased you’ve come forward for screening. If you’re feeling worried – please let us know! We can talk things through and may be able to suggest practical solutions that it will make it a bit easier for you.”

To find out more about cervical screening, visit Jo’s Cervical Cancer Trust at www.jostrust.org.uk. They have a wide range of information, including information on screening and cancer, women’s stories of cervical cancer, translated videos and more.

Practice nurse: Aysha Badat

Practice Nurse Aysha Badat often shares her personal experience of having smear tests with women who attend her cervical screening clinic.
Aysha says: “Everyone’s experience is different. When I had my first smear in my early twenties, I had no health knowledge. I had a tilted cervix which made the procedure more uncomfortable than it should have been and made me more tense and anxious. This was not explained to me during the process and, unfortunately, I didn’t go back for subsequent smear tests again for many years after.
“It was only when I started my cytology training as a Practice Nurse, that I understood why having a smear is so important and I made a pledge to myself to always have my smears when they are due.
“Now cervical screening is a big passion of mine, and despite progressing as an Advanced Clinical Practitioner, I continue to work as a Practice Nurse and Cytology Mentor to help other health professionals achieve the skills and competency, ensuring that women are counselled and educated using language they can understand to ensure women have a good experience when they come in for their appointment promoting regular screening.”

Aysha recognises the embarrassment many women feel when it’s time for their smear test. She adds: “I have the same anxieties that other women have when my smear appointment is due, but I know how important it is. The language used is very important to me and can help women feel at ease and reassured, alleviating any anxieties and concerns they may have, making them less panicked and uncomfortable about the procedure.
“There may be cultural embarrassment and religious beliefs which I like to discuss with patients giving them options, for example, to bring their own chaperone including husbands or partners, and being conscientious of cultural diversity, privacy and dignity. I make sure the patient understands the procedure before starting and distract them by talking about the weather. Before they know it, it’s done, and they often say ‘was that it?’.
“I encourage all eligible people to attend smears and get rid of the embarrassment. It’s no different to having babies! And if babies are important to you, then so is your cervix.”

Practice nurse: Lara Rimmer

Lara Rimmer, a Practice Nurse at St Pauls Medical Centre in Blackpool, urges women to get in touch with their GP practice if they’ve got any questions about cervical screening. She says:
“Cervical screening remains one of the most successful screening programmes in the world at preventing cancer.
“I understand that attending a smear test can seem very daunting and its quite normal to feel anxious about it.
“Often, we find that some women are embarrassed, because it is quite an intimate procedure or scared that it might hurt, but we really encourage you to come and talk to us about any questions or concerns you may have, ahead of your appointment. You don’t need to feel embarrassed with your practice nurse, we are there to support you in any way that we can.
“Although the screening can be slightly uncomfortable, it won’t hurt – we are always happy to accommodate any specific needs to ensure your smear experience is a positive one.
“Our job is not only to perform this quick procedure, but to also provide you with the support and information you need for you to feel comfortable. After the appointment, we often find that women are surprised by how quick, painless and straightforward the procedure is.
“Some patients feel more comfortable bringing someone along to their appointment and we encourage you to do this if you wish.
“We also know you have a busy lives’ and finding time for appointments can be a challenge. That’s why early morning, evening and weekend appointments are available so we can fit around your busy schedule.
“If you have any concerns about booking your appointment, PLEASE don’t ignore it. Contact your GP practice and a nurse will be very happy to contact you back.”