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Cervical cancer: Test that saved young mum’s life
Raising awareness and saving lives for Cervical Screening Awareness Week: The story of Emmeline Collin who had no reason to think anything was wrong when she went for a routine smear test.
But – despite having no symptoms at all – the Whittlesey mum-of-one was diagnosed with cervical cancer, which may have killed her had it not been picked up on the test.
Now, just over a year later, the 33-year-old has had surgery to remove the cancer, which was caught early enough for her to have an excellent chance of a complete recovery.
Emmeline is a prime example of why cervical screening can be a life-saver, a fact which is at the core of Cervical Screening Awareness Week, which starts on Monday (7 June).
Emmeline said: “There was no way I knew there was anything wrong – I just went for a routine smear as if I was going to buy a pint of milk.
“I had no symptoms and no worries. If I’d ignored the screening letter and thought I didn’t need to go because there was nothing wrong with me, then goodness knows what would have happened.
“I had an invasive cancer growing inside me that I knew nothing about.
“If I hadn’t gone, worst case scenario is that I might not be here, or I could have left it so late that I might have had to have much worse treatment.”
Currently, 20 per cent of UK women do not attend cervical screening appointments, putting themselves at risk of becoming one of the 2,828 women in the country who develop cervical cancer every year. Around 1,000 die from the disease.
Jo’s Cervical Cancer Trust, the charity behind the awareness week, wants to get the message across to all women that cervical cancer is largely preventable. It is estimated screening saves 4,500 lives a year.
If it is not caught early, treatment may be aggressive, such as hysterectomy or radiotherapy.
But if caught early, patients like Emmeline can avoid such trauma. She had a trachelectomy, a relatively new treatment which is not yet widely available, which preserves a woman’s fertility.
The surgery, which can be performed on some women who have very early invasive cervical cancer, involves removing the cervix and the lymph glands in the pelvic area, but leaving the womb in place.
Emmeline said: “I’ve been left with the opportunity of having another child, which I would have lost if I didn’t go for the screening.”
Cervical cancer and the importance of screening was brought to the public’s attention in March last year, when Big Brother star Jade Goody died from the disease. The 27-year-old mother-of-two had abnormal cells removed from her cervix on several occasions, but did not have a follow up screening after abnormal results from a smear test were once again found.
While her untimely death last year was tragic, it led to a 12per cent rise in the number of women having smear tests – from 3.2 million to 3.6 million.
Emmeline said: “I suppose some women, particularly the younger ones, might think they don’t need to go for a smear because they’re all right and it’s easier not to go.
“But without being a doom-monger, there could be something wrong and, if they don’t go for screening, they won’t know until it’s too late.”
Around 300,000 UK women have abnormal smears every year and they will usually be recalled for a colposcopy, where a doctor uses a colposcope to magnify the cervix to see if further treatment is needed.
The colposcopy takes just 10 to 15 minutes and is usually performed on an out-patient basis, without a stay in hospital.
Depending on the severity of the abnormality, no treatment may be required as the body’s immune system will sometimes deal with the abnormal cells itself. Alternatively, the cells may be treated there and then, or a biopsy may be taken to ascertain whether the cells are cancerous, in which case, surgery may be the next step.
Treatment after abnormal cells are detected is very successful, with more than 90 per cent of patients returning normal smear results.
Nearly all cases of cervical cancer are caused by the human papilloma virus (HPV), which is transmitted through sexual contact.
Although there is no treatment for the virus, 12 to 13-year-old girls are now being vaccinated against the two most common high risk HPV types.
Emmeline’s doctor, gynaecological oncologist Robin Crawford, of Addenbrooke’s Hospital, Cambridge, said symptoms that indicate there may be a problem with the cervix can range from bleeding between periods or after sex, to post-menopausal bleeding.
Such symptoms can also indicate other conditions, so he says it is important for women to get checked out.
He said: “There may be no problem and the abnormality is detected by screening, hence the importance of keeping up to date with smears.
“Emmeline had her cancer detected before she had any symptoms and is able to consider a further pregnancy. You could call this a triumph for the screening programme.”
In England, the cervical screening programme starts at the age of 25, with three-yearly smears until the age of 49, when the frequency is changed to five-yearly. In Scotland and Wales the screening programme starts at the age of 20.
Dr Crawford says the 20 per cent of women who do not go for screening may simply be frightened of what the test could find, or even fear that they being judged if the smear is abnormal. He said: “Some women just find it uncomfortable or have had a bad experience when they’ve had a smear before. In some cases, it’s a matter of priorities and time - the smear is the least of their worries compared with work and children.”
Robert Music, director of Jo’s Cervical Cancer Trust, says that – despite regular cervical screening cutting cervical cancer by 44 per cent since 1975 – there are still worries about the number of women who miss their tests.
Around one in three of those aged under 35 miss their screening appointment.
Mr Music stresses that while 400,000 more women had smear tests after Jade Goody’s death, figures released later this year are likely to confirm that the effect has diminished. He added: “From speaking to people involved with screening, the numbers are going down already and are potentially close to pre-Jade levels.
“Cervical cancer is largely preventable and it’s just trying to get that message across so that women will be pro-active in taking steps to reduce their risk.”
He explained that part of the uptake problem stems from the fact that there is a lack of understanding about what screening is for, with some women thinking it’s a test for cancer. It’s about preventing cancer and that’s a key message to get out there.
“We’re talking about a few minutes for a test that could potentially save your life.”
For more information, visit www.jostrust.org.uk.
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