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The NHS Cervical Screening Programme was introduced in England during 1964, aiming to detect abnormalities within the cervix that could, if left untreated, develop into cancer.
In 1988 the Department of Health instructed all district health authorities to introduce a computerised call-recall system and recommended that women aged 20 to 64 should participate in cervical cancer screening every 3 to 5 years.
The screening age of women in the in England has since been raised to 25 to 64; however it remains 20 to 64 years old in Wales, Scotland and Ireland. There has been much debate about reducing the screening age in England again, following Jade Goody’s highly publicised battle with cervical cancer, who sadly died from the disease aged just 27. However, as the disease is very rare in young women, cervical screening of women aged under 25 was not deemed justified and this proposal was rejected.
Liquid based cytology (LBC) is a new way of preparing cervical samples for examination in the laboratory. The sample is collected in a similar way to the Pap smear, using a special device (spatula) which brushes cells from the neck of the womb.
The Pap smear required the sample to be smeared onto a microscope slide, whereas for LBC samples the head of the spatula, where the cells are lodged, is broken off into a small glass vial containing preservative fluid, or rinsed directly into the preservative fluid.
The sample is sent to the laboratory where it is spun and treated to remove obscuring material, for example mucus or pus, and a representative sample of the remaining cells is taken. A thin layer of the cells is deposited onto a slide. The slide is examined in the usual way under a microscope by a cytologist.
The introduction of LBC has led to a reduction in inadequate sample rates (from 9% to 2.9% in 2008), which is of considerable benefit to women in terms of reducing anxiety, uncertainty and the need for repeat tests, so fewer women now need a second test. A faster turnaround time in the laboratory also means that women get their results more quickly.
Since September 2008 there has been a national programme to vaccinate girls aged 12-13 against human papilloma virus (HPV). This has been administered largely through secondary schools and consists of three injections that are given over a six-month period.
HPV is the name of a family of common viruses that affect the skin and the mucus membranes (moist tissue that lines parts of the body), such as those in your cervix, anus, mouth and throat.
Certain types of human papilloma virus can cause changes to the cells of the cervix, notably types 16 and 18, 31 and 33, which have been confirmed as agents which cause cervical cancer. 'High risk' HPV types have been found to be present in close to 100% of all cervical cancers. If you have repeated infections with these high-risk types of HPV, you are more at risk of developing cancerous cells in your cervix.
It is estimated that eight out of 10 people in the UK are infected with HPV at some point in their lifetime. For most people, the virus goes away without treatment and does not cause any harm. But infection with some types of HPV can cause abnormal tissue growth and other changes to cells, which can lead to cervical cancer. Other forms of HPV can cause genital warts.
HPV infection is passed on through skin-to-skin contact. The types of HPV that can cause abnormalities in the cells of your cervix are transmitted through sexual contact.
Being screened regularly means that any abnormal changes in the cervix can be identified early on and, if necessary, treated to stop cancer developing. It is estimated that early detection and treatment can prevent up to 75% of cervical cancers from developing.