CERVICAL CANCER DIAGNOSIS

Cervical smear tests can pick up changes in the cervix before cancer develops or detect cancer at a very early stage. The doctor will then organise other investigations. He may repeat the cervical smear or advise you to have a colposcopy.

A woman may present to her doctor with signs of cervical cancer or abnormal cells may be identified during a smear test. The doctor may at first order a repeat smear before carrying out any futher tests.

The cervical smear test, which was introduced in the 1940s, has significantly improved detection rates and the chance of successful treatment for cervical cancer.

It is used to diagnose or screen for cancerous or pre-cancerous cells, which can then be treated before they develop into invasive cancer (cancer that has spread). They can also detect abnormal cells, referred to as cervical intra-epithelial neoplasia (CIN). The majority of women with these abnormal cervical cells will not develop cancer.

Women are advised to go for their first smear test at the age of 25 or soon after they become sexually active. They should then go for a second follow-up a year later and at 3- to 5-year intervals thereafter.

Many women worry about what is involved in having a smear test - they may feel it is embarrassing or are scared it may be painful. Really there is nothing to worry about. Smear tests are very simple procedures, which only take about 5 minutes. Admittedly you may feel a slight discomfort but the whole thing is relatively quick and painless. The test involves an internal examination using a spatula-like device called a speculum. The speculum is inserted into the vagina and cells are scraped off the cervix. These cells are then placed on a slide and viewed under a microscope.

If any abnormal cells are seen, a repeat smear is requested. If the abnormalities are confirmed treatment can be initiated at an early stage.

The smear test is prone to false-positive and false-negative results. False-positives are worrying for the woman as she has to be called back for a repeat smear following a positive result for abnormal cells during her first test. False-negatives are a real problem as the abnormal cells go undetected. For this reason it is important for women to have regular cervical smear tests from the time that they become sexually active.

The cervical smear test is available from:

The first phase of a national screening programme in Ireland, which aims to reduce the incidence and death rate from cervical cancer in this country, was launched in October 2000. Phase one of the programme, which is part of the national cancer strategy, covers the Mid-Western Health Board area. Approximately 67,000 women in the 25-60 year age group will be offered screening free-of-charge at minimum intervals of five years.

Cervical cancer may also be diagnosed by means of a colposcopy. This is an internal examination whereby the cervix is coated with a special solution so the abnormal areas show up more clearly. The doctor passes a colposcope (tube with a view system that magnifies the cervix) into the vagina to view the cervix. Cervical cells can then be removed and studied under a microscope.

Abnormal areas (which might lead to cancer) visible through the colposcope can be destroyed using laser or diathermy (burning) therapy or a cone biopsy may be taken. This involves removing a cone shaped piece of the cervix. The biopsy may contain all the abnormal or cancer cells in which case further treatment is not required.

If cervical cancer is identified, further investigations are often required to establish the stage of the tumour and identify any secondary cancer deposits in other parts of the body: