Screening for Gynaecological Cancers

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Screening for Cervical Cancer

Cervical cancer screening aims to identify ‘at risk’ women and prevent cancer of the neck of the womb (cervix) by detecting and treating early abnormalities.  If these abnormalities remain undetected, they may lead to cervical cancer over a period of time. Regular screening reduces the risk of cervical cancer by 90%.

Cervical screening is performed by scraping superficial cells from the neck of the womb using a soft brush and looking for abnormal changes in these cells in the laboratory.

It also gives the additional benefit of testing for high risk subtypes of the human papilloma virus (HPV) as these have a higher risk of leading to cervical cancer. There are about 100 types of wart viruses, of which types 16, 18, 31, 33 and 45 are more associated with cervical intra-epithelial neoplasia (CIN, pre-cancer) and invasive cancer.

Taking a cervical smear may be uncomfortable but is generally not painful in most women.  Screening on the NHS starts at 25 by invitation, and is then at 3 yearly intervals between the years of 25 to 49 and 5 yearly from age 50 to 64 (NHS cervical screening programme).

Earlier and more frequent screening is available in the private sector. Many women prefer annual cervical smears for peace of mind. At Women’s Health Care Ltd, we can offer you cervical smears, HPV and colposcopy for peace of mind and timely reassurance.

On detection of abnormal cells and/or high risk HPV subtypes, the woman is referred for colposcopy.

Screening for Ovarian Cancer

Screening for ovarian cancer is difficult with low sensitivity and low detection rates. The aim is to detect ovarian cancer before appearance of any symptoms, as early detection helps in better outcome of treatment. For any screening to be effective, there must be a simple test which should be reliable enough to detect cancer or pre-cancer and also must not give too many false positive results in those who do not have cancer.

Assessing the ovaries by transvaginal ultrasound and measurement of  CA125 in the blood are two tests currently used to identify ovarian cancer at an early stage. Although the predictive accuracy in detecting ovarian cancer is variable, a low CA 125 level and normal ovaries on transvaginal scan are reassuring that epithelial ovarian cancer is unlikely to be present.  Some women prefer an annual screen for reassurance, and at Women’s Health Care Ltd, we can offer you both an ultrasound scan of the ovaries and a blood test for CA125.

Screening for Endometrial Cancer

On reaching menopause, all women should be informed about the risks and symptoms of endometrial cancer and strongly encouraged to report any unexpected bleeding or spotting to their GP or gynaecologist. At this time, there are no screening tests or exams to find endometrial cancer early in women who are at average risk for endometrial cancer  and have no symptoms.  Cervical smear which screens women for cervical cancer, can occasionally find some early endometrial cancers, but it’s not a good test for this type of cancer.

Women at increased risk should be advised to see their doctor whenever they have any abnormal vaginal bleeding. This includes women whose risk of endometrial cancer is increased due to increasing age, late menopause, never giving birth, infertility, obesity, diabetes, high blood pressure, estrogen treatment, or tamoxifen therapy.

Any bleeding after menopause is a suspicious sign and the woman must see her doctor immediately. Women who have several family members affected by bowel, breast,  and ovarian cancer are at high risk of endometrial cancer, and must report unusual or postmenopausal bleeding immediately.

Investigations for postmenopausal bleeding are a pelvic ultrasound scan and a biopsy from the lining of the womb (endometrial biopsy).