Doctor stresses they have 'seen it all before' as women blame embarrassment for avoiding smear tests

Alexandra Thompson
Practice Nurse/doctor doing smear test
More than a quarter of women invited for a smear test in the UK fail to attend. [Photo: Getty]

A doctor is reassuring women they have nothing to be embarrassed about when it comes to smear tests.

Screenings check the health of the cervix to help ward off cancer before it strikes, according to the NHS.

READ MORE: DIY smear tests could be a 'game changer'

The “Jade Goody effect” caused attendance to spike to 70% higher than normal when she died of the disease aged 27 in 2009.

More than a decade later, over a quarter of those invited for a screening fail to attend, with check-ups at a 21-year low in England, according to Jo’s Cervical Cancer Trust.

With many feeling bashful about being checked over “down there”, Dr Sue Sherman (PhD) from Keele University stresses doctors have “seen it all before”.

“It’s natural to feel embarrassed, it’s a private area of your body,” she told Yahoo UK.

“Medical professionals have seen it all before.

“They’re not judging you, they’re just interested in your cervix.”

Dr Sherman, a psychology lecturer with expertise in cervical cancer, recommends asking for a female nurse if it makes you feel more comfortable.

Cervical cancer affects around 3,100 new women every year in the UK, Cancer Research UK statistics show.

In the US, 13,800 are expected to be diagnosed by the end of the year, according to the American Cancer Society.

Since the nationwide cervical screening programme was rolled out in the UK in 1988, thousands of cases are said to have been prevented.

READ MORE: Thousands of women admit to skipping their smear tests

Embarrassment is not the only obstacle that holds women back from the life-saving check-up.

During a cervical screening, a small sample of cells is taken from the cervix for testing.

This involves placing a smooth, tube-shaped device called a speculum into the vagina. Lubricant may be used.

Opening the speculum makes the cervix visible.

Using a soft brush, the nurse collects cells. The speculum is then closed and removed.

Some report finding this uncomfortable, however, the whole thing lasts less than five minutes.

“Comfort varies from woman-to-woman,” Dr Sherman said.

“The more anxious you get, the more your muscles tighten up, which can make it more painful.

“Tell your nurse you’re anxious and they may take more time over it.”

The NHS recommends asking your nurse to use a smaller speculum if it feels uncomfortable.

You could also try lying in a different position, such as on your side with your knees to your chest rather than on your back.

Listening to music, reading or bringing a loved one along for support may also help you relax.

“It’s not a procedure anyone looks forward to,” Dr Sherman said.

“If it’s uncomfortable, I’d rather that for a short period of time and know I was protected.”

Some women are willing to go, but struggle to make an appointment.

A survey by Jo’s Trust found one in 10 women were only offered times they could not make when they last tried to book, while 7% were told no appointments were available whatsoever.

“Some surgeries offer opening hours that are extended a bit,” Dr Sherman said.

“It’s one of those things that’s worth scheduling in.

“It’s worth persevering to get an appointment.”

Teal ribbon awareness on woman's hand for Ovarian Cancer, Polycystic Ovary Syndrome (PCOS) disease, Post Traumatic Stress Disorder (PTSD), Tourette's Syndrome, Obsessive Compulsive Disorder (OCD)
Cervical cancer affects around 3,100 new women every year in the UK. [Photo: Getty]

What does a smear test involve?

The NHS is moving towards testing for HPV, rather than looking at cell changes, during a cervical screening.

HPV is a common virus that infects four in five Brits at some point in their lives, according to Jo’s Cervical Cancer Trust.

Once infected, via sexual contact, most fight off the virus naturally.

Yet, of the more than 200 HPV strains, 13 have been linked to cancer.

Testing for HPV is the same “smear experience” for a woman as checking for abnormal cells.

After the screening, the next step depends on whether HPV is detected. Results are usually available within two weeks.

If HPV is present but no cell changes have occurred, most are invited for a second screening in a year’s time.

When cell changes are abnormal, a woman may be invited for a colposcopy, which allows for closer examination of the cervix.

READ MORE: Urine test could mark the end of smear tests

Around 40% of colposcopy results come back clear, according to Jo’s Cervical Cancer Trust.

In very rare cases, colposcopies reveal a woman has cancer.

Most of the time, they show up abnormalities on the cervix’s surface.

This is usually treated via large loop excision of the transformation zone (LLETZ).

LLETZ involves using a thin wire loop with an electrical current to remove the area of the cervix with cell changes.

The removed area is then sent off for tests to determine the extent of the cell abnormalities.

If cell changes are higher up the cervical canal, a thin straight wire is used rather than a loop.

Alternatively, a cone biopsy may be carried out to remove a funnel-shaped piece of tissue from the cervix.

If abnormal cells remain, lasers or heat may be used to “burn” away the affected tissue.

Extreme cold cryotherapy could also help.

Nine in 10 women do not have abnormal cell changes again after the above treatments, according to Jo’s Cervical Cancer Trust.

The charity adds around three quarters (75%) of cases are prevented due to screening.

Along with the HPV vaccine, smear tests are “the best way to protect against” the disease.