In this two-part series, Jenna, and GPs, Dr Owolabi and Natasha Behl, explain how cervical screening and vaccination against human papillomavirus (HPV), could eliminate cervical cancer and help protect us all against other cancers.

Jenna was 25 when she was told after her first cervical screening that she had HPV, increasing her risk of cervical cancer. There was no need for treatment straight away and she was advised to return for further screening in six months. But it was two years before she went back and learned the HPV had caused cervical cell changes (abnormal cells).  Jenna had treatment to remove these cells.

Is cervical screen for me?

Dr Bola Owolabi, a Midlands GP and national director of healthcare inequalities, says it’s important to know about cervical screening. It’s available to women and people with a cervix, which is the opening to the womb, who are aged 25 to 64. Please don’t think it’s unnecessary because you are young, or older.”

“When I was 25, I went for my first screening,” explains Jenna, “I was told that I had HPV and borderline cervical cell changes. This meant that it was possible that I would need another cervical screen in 6 months-time just to ensure there wasn’t anything worrying developing.”

Cervical screening only takes a few minutes and could save your life, but some people are missing out, says Bola.

“Some people forget to act on their invite, or struggle to fit it in around work or caring responsibilities. For others, embarrassment, fear, a lack of symptoms or misinformation means they don’t realise the importance of attending screening. 

“If you have a cervix and have had any kind of sexual contact at any time with anyone, no matter how long ago, please go for cervical screening when invited.”

We are here for you

Jenna says: “Unfortunately, I didn’t have a great experience at the first screening. The doctor asked me about my sexual activity and I felt like they were shaming me when I answered. I was too worried to go back.”

“Jenna should never have been made to feel that way,” says GP Natasha Behl, “We are here to help people take-up this life saving service.”

Jenna continues: “Two years later I still hadn’t gone back. That year my partner had a very sudden heart attack. It was a bit of a wake-up call and I decided I should look after my own health.

“My test could not have been more different. I told the nurse that I was worried because my last test was such a bad experience, and I didn’t know if the HPV was still there.

“The nurse was lovely – she took her time, listened to me, and really went out of her way to look after me.”

Dr Behl is pleased that Jenna felt supported during her screening. “As staff we know people can feel very vulnerable. We need to help them to understand the procedure and to feel comfortable.

“For example, reminding them they can check the appointment is with a female clinician. Letting them know they can ask for a different-sized speculum, which is a piece of equipment we use during screening if they are uncomfortable.

 “Please also seek help before your appointment, if you have had a traumatic past experience, suffered abuse, a difficult pregnancy or just feel scared about it. Contact  a charity such as Jo’s Cervical Cancer Trust the Caribbean and African Health Network (CAHN) or Safeena Muslim Cancer Support.

Your cervical screening results

During the procedure a small sample of cells are taken from the cervix, using a small type of brush by a health professional. This is then checked for a type of virus called HPV.  If detected early we have effective treatments to remove any abnormal cells caused by the high-risk HPV infection, to prevent cancer.

Following screening many people receive their results letters and no further action is needed. Dr Behl says: “HPV DNA is found in over 99% of cervical cancers – if you don’t have high-risk HPV your risk of cervical cancer is very low and you do not need any further tests, so will be for screening again in 3 or 5 years.

“If HPV is found in your sample, but there isn’t any evidence of abnormal cell changes, you may need another cervical screening appointment in one year.

“If HPV is found and you have abnormal cell changes, you might need a colposcopy. This is a simple procedure to look at your cervix. A biopsy (small sample) of cells might be taken to test how much change has occurred in your cells.”

Dealing with my results

“I had cell changes, meaning they had got worse since my last test.” Jenna adds.

“At first, I didn’t want to speak to anyone about my results as I felt like it was a taboo topic, partly the fear of having cancer and partly because it was not spoken about much at school. My generation did not have the HPV vaccine, and no one really talked to us about sexual health or STIs. 

“I’m Arab and mixed race and for me, there was the shame in our culture around sex. It’s often internalised. You don’t really talk to others in the community about sex.

“Finding people who are like you in some way to talk these things through can be really helpful. Someone who understands what you’re going through and can understand why you might be uncomfortable. I also found the Jo’s Trust website really reassuring.”

Moving beyond screening

Dr Behl explains: “Having high-risk HPV with cervical cell changes doesn’t mean you have cancer, but the medical team might recommend a colposcopy (a procedure to look at the cervix) or treatment.”

Jenna describes her appointment. “Going for colposcopy can be nerve-wracking and I was really nervous!

“The team were fantastic and really careful. They gave me two options – I could have my changed cells removed, or I could wait six months to see if the cells had gone back to normal by themselves.

“I decided to have treatment. The team fully explained the potential risks of treatment, but for me there was no question – I didn’t want to worry about it developing into cancer.

“Luckily for me, the procedure was totally painless.

“At my next colposcopy, everything was clear and now I am back onto regular cervical screening tests every three years. That minor inconvenience might have saved my life though so I’m really passionate about sharing my experience to hopefully help someone else to book a test.”

Eliminating cervical cancer

National charity Jo’s Trust reports that every day in the UK, two women lose their lives to cervical cancer. NHS England has committed to eliminate cervical cancer by 2040.  

“HPV vaccination and attending cervical screening is crucial to eliminate cervical cancer,” says Dr Owolabi.

If you have a cervix but either aren’t registered with a GP or are registered with a GP as male, you might not be routinely invited for breast screening or cervical screening.

Dr Owolabi says: “Please request access through your GP practice. If you don’t have a GP, you can register for free and don’t need a permanent address or leave to remain in the UK.  You may also be able to get cervical screening through a sexual health or walk-in centre.”

Information about the HPV vaccine and NHS screening programmes can be found on www.nhs.uk, or in different languages and easy-read formats at www.gov.uk/screening and see NHS screening information for trans and non-binary people at www.gov.uk.