It’s a Smear Campaign! Find out about it…..warts and all!

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It’s a Smear Campaign! Find out about it…..warts and all!

“DOCTOR AT SEA” a monthly Column in The Islander Magazine

It’s a Smear Campaign! Find out about it…..warts and all!

In April, taking a swab for warts, or Human Papilloma Virus (HPV) was added to the UK’s regular “Smear” programme to try to reduce the deaths from cancer of the cervix. At present these tests are just available in a couple of centres but will roll out to the rest of the country soon.

The age at which different countries start their screening program varies, as does the interval between “smears” (UK 3-5 years, Australia 1 year, USA 2 years) and the USA already include a swab for HPV. Vaccination against HPV was also started in 12-13 years old girls in 2008 with a catch-up programme for 18 year olds.

The “Pap smear” test is familiar to most female yachties and most are keen to keep up to date even when away from their usual home base. Many have heard of the “Jane Goody Effect” where requests for smears surged in the few months after the death of the reality star from cervical cancer in 2009. But “smears” alone are not the whole story!

In the “Pap test” cells are taken from the neck of the womb with a small wooden stick or brush and either smeared onto a glass slide, or floated in some special fluid to preserve them. They are then dyed and looked at by a specialist and this all takes time.

Also the reports can be confusing because the way laboratories report the results also differs between countries and laboratories. We see words like “dyskariosis” and abbreviations like ASCUS…atypical squamous cells of unknown significance; BNA…borderline nuclear abnormality; SIL… squamous intraepithelial lesions ….and CIN…cervical intraepithelial neoplasia…..!!!! It’s no wonder we get confused if we look on line!

But why are warts important?

To summarise; it is thought now that cancer of the cervix can be regarded as a sort-of sexually transmitted disease. All cases of cervical cancer are associated with HPV virus infection, but not all HPV infections cause cancer. Women, who have never had sex, don’t get cervical cancer. It is more common in those who have had many sexual partners in a short space of time, who are very young when they first have sex and who smoke.

There are over 100 types of wart virus and most cause no problems at all. 80% of women in the UK have antibodies to one or other HPV virus by their mid 20s, but 90% of those will be gone again after 2 years. Some wart viruses cause visible genital warts, which are unsightly but harmless and don’t lead on to cancer. Only a few “high-risk” viruses if they stay around inside the cervical cells lead on to abnormal smears and possibly eventually cervical cancer.

What’s the take home message here in Palma now?

Well…….keep on having your “smear” test. If it shows more than minor changes then “Colposcopy” referral is usually suggested so that the cervix can be examined directly under the microscope. This gives more accurate diagnosis than the smear and treatment can often be offered at the same time. This should not affect future fertility or cause other long-term problems.

The HPV test in Palma costs about 120 Euros and the lab will test for 15 different types of the virus, including all those which can cause cancer.

If you have a slightly abnormal smear on several occasions, then it is worth getting the HPV done. If it’s negative then your risks are very low and you can return to your usual recall.

If positive then you will be able to access treatment earlier.

Dr Rosemary Prudhoe, can be contacted at Club de Mar Medical Centre, Palma de Mallorca.

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