Cervical Cancer Signs and Screening – #SmearForSmear

This week is Cervical Cancer Prevention Week, so today Jackie Linehan, Legal Director in our Bristol office, looks at the profile of this prevalent but preventable cancer.

Cervical cancer arises in the cervix and is due to the abnormal growth of cells  which can spread to other parts of the body.  Around 3,200 cases of cervical cancer are diagnosed in the UK each year and it is the second most common type of cancer in women in the UK. More than half of cases are diagnosed in women under 45.

• 9 Women are diagnosed with cervical cancer each day
• 2 women lose their lives to cervical cancer every day
• 75% of cervical cancers can be prevented by cervical screening.

Thankfully cervical cancer is preventable and treatable; but only if it is caught early, therefore, raising awareness of the signs and symptoms and attending regular cervical screenings (smear tests) is imperative.

Signs of Cervical Cancer

It is always sensible to be aware of the signs and symptoms of any serious condition or illness.  However, it is particularly important with cervical cancer, as the signs and symptoms are not always obvious or indicative of the condition.

Therefore, it is vital to attend routine cervical screening appointments, as this may detect the presence of abnormal cells in the cervix. If treated early, this may prevent the abnormal cells from developing into cervical cancer.

Checking for the signs and symptoms of cervical cancer, and interpreting them correctly, is critical in diagnosing cervical cancer and managing the appropriate treatment.

It is extremely important to familiarise yourself with and be aware of the key, early signs and symptoms of cervical cancer.  It’s important to highlight that the issues listed below are not always caused by cervical cancer, but if they do arise, they must be checked by a doctor as they could indicate cervical cancer:

• Unusual bleeding – for example in between periods or after sex (post-coital bleeding)
  • Discomfort or pain during sex
  • Unusual or unpleasant smelling vaginal discharge
  • Vaginal bleeding after the menopause
  • Pain the in the pelvis or lower back

In advanced cases of cervical cancer, where the cancer had spread into tissues surrounding the organs (known as metastasizing), it can trigger other signs and symptoms such as:

• Constipation
  • Blood in your urine
  • Loss of bladder control
  • Bone pain
  • Swelling of one of your legs
  • Severe pain in the side of your back caused by swelling in the kidneys
  • Changes to bladder or bowel habits
  • Loss of appetite
  • Weight loss
  • Tiredness and lack of energy

Cervical cancer delayed diagnosis

Cervical cancer misdiagnosis or delays in diagnosis most commonly occur when the signs and symptoms identified above are overlooked by a doctor, mistaken for other conditions, or attributed to heavy periods or put down to the effects of the menopause.   In some cases, medication can be prescribed to manage and control these signs and symptoms, which could therefore mask the presence of cervical cancer. As Cervical Cancer is rare in women under 25 screening is not offered.  If you are under 25 and have symptoms get them checked.

If you are worried that you may have cervical cancer review the NHS page on Cervical cancer and visit your GP to raise your concerns.

Your doctor should always take a detailed history from you, which includes checking when your last smear test was undertaken.  It is crucial for your doctor to take any reported signs or symptoms seriously, regardless of your age.

If there is any cause for concern, your doctor should arrange for further investigations and treatment, where necessary. This will sometimes include a vaginal examination and/or a referral to a specialist gynaecology department at a hospital, ideally within two weeks.

If cervical cancer is misdiagnosed or there is a delay in diagnosing the condition; and it is diagnosed at an advanced stage, more aggressive and radical treatment may be required to manage and treat the condition. Such treatments may have not have been required if the condition was diagnosed at an earlier stage.  This can include unnecessary hysterectomies or unpleasant treatments such as chemotherapy or radiotherapy. In some cases, we have acted for families on behalf of loved ones who have sadly passed away due to cervical cancer.

Attend regular Cervical Cancer screening

All women aged 25 – 64 are offered cervical screening (known as the ‘smear test’) under the NHS. If you’re aged 25 – 49, you’ll be invited for a smear every three years, and after that it’s every five years.

Cervical screening can prevent up to 75% of cervical cancers from developing, yet 1 in 4 women fail to attend their smear test each year and in younger women (aged 25-59) this drops to 1 in 3.

Research by Jo’s Trust reveals many different barriers prevent people from attending. The simple step of finding time off work to attend cervical screening can be a challenge in itself.  More than 1/3 of women don’t find it easy to leave work in order to attend, and more than ¼ would be more encouraged to attend if their company was more flexible.

Apart from the practical difficulties, many are simply scared or embarrassed, and plenty of women have stories of how painful or uncomfortable they have found the test. However, according to Jo’s Trust;

The procedure should not be painful, but some women can experience a degree of discomfort and even short-term mild pain… Speculums come in different sizes so you can ask for a smaller one to be used if you are uncomfortable/in pain.

Is there any alternative to the smear test?

Not exactly, however you can now take a test for HPV (Human Papilloma Virus, the cause of most cervical cancers) using a ‘do-it-yourself’ home test kit. These are offered by several companies, for example GynaeCheck. GynaeCheck will post you a kit which collects a fluid sample, you then post back this back in a pre-paid envelope and receive your results within 10 days. The company promises that the process involves no pain and takes only 5 minutes. According to Jullien Brady, consultant gynaecologist;

The test looks for the high-risk strains of HPV, so if you have a negative result you know you are at a low-risk of developing cervical cancer and are advised to test again in two years’ time. If you do carry the high-risk strains of HPV, you’ll need to go for your smear test to make sure the HPV infection has not caused changes to your cervical cells.

However, at the moment this form of cervical screening is not available on the NHS and the kit costs £129. Jo’s Trust is calling for more research into HPV self-testing. According to their recent study, 1 in 4 women who have delayed attending a smear want the opportunity to self-test, and Jo’s Trust believe that offering this option for cervical screening would overcome many of the barriers that exist.

A smear test is certainly not something to look forward to, but five minutes of potential discomfort could save your life. You can find more information at www.jostrust.org.uk

If you believe that a delay in your diagnosis or treatment has led to a worsening of your illness, it may be something you would like to discuss with a solicitor. Call our dedicated team of specialists for a free, confidential discussion on 0800 044 8488.