Regular screening best weapon to stop cervical cancer in its tracks
Experienced research nurses, Tina Pritchard and Donna Roberts
explain how research at
Saint Mary's Hospital is supplementing regular smear tests in
the fight against cervical cancer.
Did you know that cervical cancer is the third most
common cancer in women?
Over 3,000 women are diagnosed in the UK each year, but since
routine screening was introduced by in the 1980s, rates of cervical
cancer have halved in women who attend their regular smear
Rates of cervical cancer halved as a result of regular
In the UK, women aged 25-64 years are invited to have a cervical
screening examination, usually either every three or five years
depending on their age. Research nurse, Donna describes the
procedure: "A smear test takes a sample of cells from
the cervix and checks them for abnormalities in the laboratory.
Changes to cells on the surface of the cervix are common and
treatment is generally straight forward. The standard clinical
treatments for dealing with abnormal cervical cells are generally
straight forward and can be provided in the clinic. They include
LASER therapy, loop excision, cryotherapy (freezing treatment) and
cold coagulation (heat treatment).
"Most cervical cancers are caused by high risk types of
the human papilloma virus (HPV)," adds Donna who specialises
in colposcopy. "HPV can cause the cells to become
abnormal over time (pre-cancerous cell changes). The colposcopy
examination allows the cervix to be examined in more detail and
treatment for the abnormal cells can be performed if
Saint Mary's Hospital recently introduced new
Zedscan technology, to provide more accurate detection of
significant changes than standard colposcopy. This technology also
means that we can provide greater reassurance for those women that
do not need treatment. TRUSTECH our innovation service provider has
been working with gynaecologists, the company Zilico and the
Greater Manchester Academic Health Science Network to evaluate and
introduce the technology into the NHS.
Women at Saint Mary's Hospital are also currently involved in an
international study, which is evaluating the effectiveness of a HPV
vaccine, in women diagnosed with specific high risk types of HPV
infection. Tina, whose role is funded by the National Institute for
Health Research (NIHR),
"There are HPV vaccines already available to reduce
the risk of HPV occurring, as part of the NHS Childhood Vaccination
Programme. This new vaccine, which is potentially a very
exciting development, is different as it is intended to clear the
infection in women with HPV and reduce the risk of their condition
progressing to cervical cancer."
Survival outcomes for women with early cervical cancer are
Although smear abnormalities are quite common, these days very
few women develop cervical cancer thanks to them being picked up by
the smear test and treated early. In the small number of
women who are unfortunate enough to get cancer, survival outcomes
are generally good, so our research is now focused on improving
quality of life.
Where cancer is identified, doctors may recommend a
hysterectomy, where the whole of the womb is removed. Through
our research we are currently investigating an alternative approach
to hysterectomy through the SHAPE study, which is funded by Cancer
Research UK and supported by the NIHR.
The SHAPE study is investigating whether an ordinary or "simple"
hysterectomy and removal of nearby lymph glands in the pelvis,
could be an alternative to the more extensive or "radical"
hysterectomy and pelvic gland removal, which has been the more
traditional treatment for women that have early cancer of the
cervix. There is already some evidence that the "simple" type
of hysterectomy is as good as the traditional treatment for small
and very early cancers. Doctors believe that by doing a less
extensive hysterectomy women may recover better with fewer long
term side effects and a better quality of life overall and the
study will investigate this.
"We recommend that women attend for regular cervical
screening when they are invited which is usually 3-5 yearly.
Women should also visit their GP promptly if they have any abnormal
discharge or bleeding. Cervical screening and HPV testing has
revolutionised gynaecological care for women over the past 30
years, and we are proud to be working at the forefront of improving
outcomes further through research."
Tina and Donna.