Posts tagged ‘smear’

January 24, 2018

Smear For Smear: a call for women to take the smear test

The statistics are impressive: 5,000 women’s lives saved annually; 94.8% tests are negative (EngNHS figs) 75% tests prevent cancer developing.

BUT

1 in 4 women don’t take up invitation to be screened, a depressing figure which rises to 1 in 3 for young women between 25 and 29 with fewer young women now choosing to be screened for cervical cancer.

There is something counter-intuitive about this trend given the growing openness towards all things sexual that young women are so coy over a procedure that takes moments and may prevent a tragically early death.

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Dr Elizabeth Macgregor

Aberdeen pioneered programmed cervical screening back in the 1960s. This progressive practice was one of many aspects of celebrated care for women’s health undertaken in the city under the remarkable Dr Dugald Baird which included access to birth control, pre-natal and post-natal care, childbirth and sexual health. Baird asked a young medical researcher, Dr Elizabeth Macgregor who had joined him in 1958, to set up screening for women in the city and the surrounding shire and to collect research statistics on its efficacy. This was in 1960, nearly 60 years ago.

Then as now cervical cancer was a major killer of young women, one that creeps up with few distinctive symptoms.

Dr Macgregor’s inspiring work in Aberdeen was based on that of the American Dr Georges Papanicolaou whose screening test in the 1940s for human papillomavirus (HPV) was known as a Pap smear. Dr Macgregor’s approach was meticulous; testing and carefully recording the impact of screening on the women under her care. Under her a systematic public health programme was introduced to tackle cervical cancer, in Aberdeen this targeted poorer women who had fewer opportunities to access health care.  Patients were invited to her clinic and through a punchcard system recalled for follow-up smears. Dr Macgregor found there was a dramatic drop in the incidences of cervical cancer in the northeast as a result of her screening clinics despite some reluctance by a number of GPs to participate – Dr Macgregor went around the northeast carrying out and analysing these smear tests herself.

In the first five years of her work a huge decrease in cervical cancer rates in northeast Scotland were recorded. Her published outcomes proved so impressive others followed her lead made all the easier through Dr Macgregor’s bank of research evidence but it was not until the late 1980s her practices were widely adopted.

In 2016 the age range for cervical screening in Scotland was changed from women between 20-60 years to those between 25 and 64. Women up to 49 are re-screened every three years and older women from 50 to 64 are re-tested every 5 years (those above this age group being followed-up when medically advisable and similarly with women younger than 25.)  

Since Dr Macgregor’s time vaccines have been developed to protect against types 16 and 18 HPV which are the main causes of cervical cancers and in 2008 Scotland introduced a programme of school-based vaccination for cervical cancer for 12 and 13 year olds. As a result early signs of these potential cancers have almost halved.

The success of the school vaccine is clear with 90% uptake among Scotland’s girls making it among the highest in the world.

Women in this country are fortunate to be able to have this dangerous disease caught early – and for free. Women in other parts of the world must be envious wondering why anyone would not jump at the opportunity.

Women of all ages keep safe – take advantage of the smear test.