Dr Woyka has a particular interest in cervical screening. She is a GP Member of the Department of Health's Advisory Committee for Cervical Screening. At the Harrow Health Care Centre we use only disposable equipment for all gynaecological procedures. Our samples are all processed by liquid based cytology at the Doctors Laboratory.
A cervical screening test helps detect changes which if left untreated may progress to the development (usually over several years) of cervical cancer. A plastic brush is used to sample the cells at the cervix (neck of the womb) and the sample is then put into a liquid transport medium. At the laboratory this liquid is filtered and transferred to a glass slide which is then assessed by a lab scientist (a cytoscreener).
This is the new technique being introduced throughout the country to replace the old cervical smear tests. The sample from the neck of the womb is taken using a plastic brush, which is transferred to a liquid. At the laboratory this liquid is processed to remove debris and then transferred in a uniform way to a slide. This results in a better produced slide for the cytoscreener (scientist who evaluate the slides) and has resulted in a more efficient way of screening. Previously about 10% of cervical smears were not satisfactory for technical purposes and with the advent of liquid based cytology this has been reduced to around 0.5 -1%. The Harrow Health Care Centre has been using liquid based cytology for several years.
We are fortunate in having a laboratory which provides very rapid answers and we undertake to report all our cervical screenings within 10 working days, although in practice we usually have the results within 3-4 days.
Current NHS guidelines are now to have cervical screening every 3 years to the age of 50 and thereafter every 5 years until the age of 64. Here at the Harrow Health Care Centre we are aware that many women would prefer to be screened more frequently. A cervical screening (cytology) is not a fool-proof test and there are also some forms of cervical cancer which are not easily detectable with cytology screening. A cervical smear (cytology) will detect approximately 50% of abnormalities and there are now other tests available which increase the reliability of your screening.
The current Government guideline is to commence screening at 24. Cervical screening in very young patients is not a reliable way of detecting cervical cancer. There is a poor association with the level of abnormalities suspected on a cervical screening and actual cancer in this age group.
Yes. A sample can also provide an HPV test and a whole host of sexually transmitted disease screening.
HPV stands for Human Papilloma Virus. There are several strains of HPV, some of which are associated with cervical cancer. An HPV test looks for the presence of particular strains of virus, which would help evaluate other cervical cell changes. If none of the worrying HPV strains are detected, this makes any minor cervical change much less concerning. It is possible HPV testing may ultimately replace the need for the cytoscreener to visually detect cervical cell changes.
We used to use a wooden spatula to sample the cells at the cervix, and then smear the sample along a slide. That resulted in rather unsatisfactory samples and around 10% of patients had to return for a repeat test. The introduction of liquid based cytology in which the sample is suspended in liquid and then transferred evenly to a slide, provides a much more reliable sample and women are no longer being recalled because of technically unsatisfactory tests. The term smear no longer seems appropriate.
The Harrow Health Care Centre is pleased to offer both vaccines to protect against cervical cancer. The new vaccines provide 100% protection against the two main strains of HPV (human papilloma virus) which cause 70-80% of all cervical cancers. Gardasil also protects against the other strains of HPV which cause ano-genital warts.
We offer a series of Sexual Health Screening pages. For further information click here.