Cervical Cancer screening in pregnancy

Cervical screening is something that you may not consider when pregnant or preparing for pregnancy.

We asked an expert from Jo’s Trust to help us answer some questions about the safety of cervical cancer screening during pregnancy.

If I am pregnant is it safe to have a cervical smear procedure?

Yes, it is perfectly safe to have a smear at any time during the pregnancy.

Should I be screened before I plan to conceive?

If you are due a smear it is always best to have this done and wait for the results to confirm everything is fine before attempting pregnancy. However, if you have had a smear within the previous 3 smears and are not due a smear, there is no need to have this repeated just because you are planning to get pregnant.

I have just given birth and have been called for a screening, will the results be affected by pregnancy hormones?

It is perfectly fine to have a smear from 6 weeks after giving birth. This is usually the time for the post-natal visit and would be a good time to have a smear taken if it was due.

Does pregnancy make my cervix more vulnerable to “abnormal cells”?

No, there is no evidence that pregnancy increases the risk of developing cervical pre-cancer or cancer.

 Some Facts and Information about Cervical Cancer

The effects of Cervical Cancer

• Every day 3 women in the UK will die of cervical cancer
• The second most common cancer in women under 35
• Each year around 2,800 women are newly diagnosed
• The chances of survival are good if the disease is caught early
• Cervical cancer is not thought to be hereditary It is a largely preventable disease

What are the symptoms of cervical cancer?

In the early stages of cervical cancer there may not be any symptoms If symptoms are experienced they can include:

• abnormal bleeding: after sexual intercourse, during or between periods
• unusual and/or unpleasant vaginal discharge
• discomfort or pain during sex lower back pain

The Human Papilloma Virus (HPV)and Cervical cancer

• HPV is a very common virus transmitted through skin to skin contact in the genital area
• Up to 75% of people of reproductive age will be infected with HPV at some point in their lives
• HPV types 16 & 18 cause 75% of all cervical cancers
• The presence of HPV is seen in 99.7% of cervical cancers
• For the majority of women this will not result in cervical cancer Cervical cancer is rare while HPV infection is common

Other risk factors…

…associated with an increased risk include:

• smoking
• cancer-causing chemicals from cigarette smoke found in the cervical mucus of women who smoke
• smokers who also have a ‘high risk’ type of HPV infection are twice as likely to get cervical cancer
• sexual activity several sexual partners
• weakened immune system
• poor diet

The impact cervical cancer can have is:-

• Physical, personal, emotional
• Invasive treatments and surgeries
• Impact on fertility Financial – work issues
• Social – impact on friends/family/work
• Devastation – life threatening disease

Who receives cervical screening?

There is a National Screening programme in England for

• women first invited for screening at 25
• saves around 4,500 lives a year
• aim is to prevent cancer
• only around 7-10% will receive an inadequate or abnormal result, with
  the majority indicating a grade of CIN, a pre-cancerous condition and
  is NOT cancer

What are Abnormal results – CIN

In the UK women who receive an abnormal smear result are usually informed
that they have a grade of cervical dyskaryosis or dysplasia.

1. Borderline smear indicates slight abnormality
2. CIN1 indicates mild changes
3. CIN2 indicates moderate changes
4. CIN3 indicates more severe changes (not cancer)

An abnormal result doesn’t necessarily mean there’s a problem. And an “inadequate” result refers to the smear, not to you.

• 1 in 20 shows CIN1. Can revert to normal without any treatment, but
  follow-up with further tests is the rule. If changes persist, may need
  colposcopy.
• 1 in 100 shows (CIN 2). These too can sometimes revert to normal,
  but it’s usual to be referred to the colposcopy clinic
• 1 in 200 shows (CIN 3). These women need referral for colposcopy
• Overall, less than 1 in 1,000 smears shows an invasive cancer. These
  women are referred straight to a specialist.

Cervical screening uptake – a concern

National Screening programme saves around 4,500 lives a year. The uptake of women attending screening is down for 13th year running with almost 1 million women who declined in 2007-2008. The attendance of women (30-34) declined from 84.3% in 1995 to 76.8% in 2007-2008. With 33.8% of women (25-29) who chose not to attend screening during the financial year 2007-2008 and 250,113 young women in England who should have been screened, were not.

The Jade Goody effect

Jade wanted to make a difference and to make something positive out of a tragedy.  The massive media interest in her story led to a huge screening uptake as well as a positive impact on the work of Jo’s Trust and a 350 % increase in demand for services in that period. By reaching this target group of young women, many lives will be saved.