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Breast Screening and Cervical Smears

By: Julie Burns - Updated: 13 May 2012 | comments*Discuss
Breast Screening Cervical Screening

Knowledge, they say, is power. Where our precious health is concerned, the more informed we are about our bodies, the better. By cultivating a 'better safe than sorry' common-sense approach we chase away fear and ignorance, raise our can-do attitude and help empower ourselves in the process. Where both breast and cervical screening are concerned, we can really help work towards safeguarding our well-being. Though the thought of it can be a bit like heading to the dentists - not necessarily pleasant in itself - the consequence cannot be over-estimated. A potential life-saver, screening should be part of every healthy woman's routine.

The Breast Screening Routine

Screening is an effective method of detecting signs of breast cancer early on and therefore at its most treatable, involving an x-ray of each breast, known as a mammogram. As it entails carefully compressing the breast while standing up, depending on breast sensitivity, it can feel unnatural, uncomfortable or plain painful.

(Actress and Breakthrough Breast Cancer charity personality Liza Goddard, who recently got over breast cancer herself, quite rightly wonders why a machine on which you lie down front first and drop your boobs through, hasn't yet been invented)…

However, the means justifies the end as having a mammogram enables small changes in breast tissue to be identified. It acts as a proven tool in picking up potential cancers too small to be felt by the woman during self-examination or even by her doctor. Expect two views of the breasts to be taken - one from above (known as craniocaudal) and one into the armpit diagonally across the breast (mediolateral).

Breast Screening Eligibility

Every year, around one and a half million UK women aged between 50-70 are screened for free by the NHS. It is advised that this is repeated every three years in a nationally co-ordinated programme that invites relevantly aged well women from GP practices in turn.

Women Under 50 Are Not Offered Routine Breast Screening

The reason why women under 50 are not offered routine screening is linked to the menopause. Mammograms are not as efficient in reading pre-menopausal women whose usual dense breast tissue makes it more difficult for problems to be picked up by screening. Official statistics for breast cancer are also lower in this age group, whereas the average onset age for menopause is 50. With menopausal change, breast glandular tissue becomes more fat-laden, therefore clearer to read on the mammogram and making x-ray results more reliable. Incidence of breast cancer is higher for post-menopausal women but women of any age can ask to be referred by their GP to a hospital breast clinic for screening, where there's a specific risk of breast cancer.

Further Breast Testing

When breast cancer is suspected or has been diagnosed, diagnostic tests such as Magnetic Resonance Imaging (MRI) are done to define the best form of treatment for the patient.

The Cervical Screening Routine

Cervical Screening works as an early detection method of preventing cancer (rather than a test for cancer). By finding and treating any abnormalities that could, if left, lead to cancer of the cervix, the first step is cervical screening.

Conventional 'smear' tests are being replaced so that by 2008, all NHS tests will be completed by liquid-based cytology (LBC). An improved way of collecting and preparing sample cervical material, it results in faster, more accurate analysis, with fewer repeat 'second' tests and the understandable anxiety these can cause.

The (mildly uncomfortable) procedure is still similar: a doctor or nurse inserts a brush type device and sweeps around the cervix for cells. Unlike the smear test where cells are literally smeared onto a slide for lab examination, the head of the brush containing the cells is broken off and put directly into preservative fluid. This sample is then specifically treated to remove any obscuring material like blood while keeping a random sample of the remaining cells. A thin layer of the cells is fixed onto a slide for microscopic examination in the usual way. It is important to note cervical screening is not perfect (by not always detecting early cell changes that could lead to cancer) but that early detection and treatment can still prevent 75% of cancers developing.

Cervical Screening Eligibility

All women from 25 to 64 are the age band invited by the NHS for free cervical screening every three to five years - and tracked and recalled thereafter.

Similar to breast screening, there are proven reasons why women in this case, under the age of 20 and over 65, are not targeted. As teenager's bodies are still in overall development, screening young women under 20 could result in incorrect abnormal smear results. Cervical cancer is considered rare in women of this age. Under the age of 25, cancer is still rare though changes in the cervix are common and become screen detectable.

In the present system, by the time a woman is 65 and has had three consecutive negative smears, she is no longer recalled. The natural pattern of cervical cancer strongly suggests that the disease will not take hold in this generation. However, women aged 65 and over who have never had a smear have test entitlement.

Exceptions to the age bracket regulations are if a woman has never been sexually active with a man. Evidence here puts the risk of cervical cancer as very low (but not impossible).Therefore, screening can be declined at each occasion for this reason.

Continued screening is recommended if a woman is not currently sexually active but has had male partners in the past.

Safe Screening

These are general guidelines in relation to NHS breast and cervical screening UK practice. If you have specific concerns relating to either but fall outside of the general age bands in each case, tell your GP as soon as possible. If you have been for screening and have queries over the result, contact the address on your original letter. Finally, if you feel you need more than standard personal care on other gynaecological or women's related health issues, you may prefer to consider a private gynaecologist. They can arrange annual smear tests as well as regular health briefings, for extra peace of mind.

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