Death rates from cervical cancer in the Republic of Ireland exceed those in all other regions in Britain and Northern Ireland because there is no national screening programme, claims a new report published in the British Journal of Cancer1.
Researchers from Cork and Belfast studied cervical cancer death rates between 1971 and 2000 in the UK and the Republic of Ireland.
They found that deaths from cervical cancer fell substantially in the UK after the national screening programme was introduced in 1988, whereas in Ireland there has been a steady increase year on year.
Experts say the introduction of a cervical screening programme in the UK has led to a fall in the incidence of the disease and a corresponding drop in deaths. They believe that Ireland must follow the UK and implement an organised population-based screening programme.
By 1993, 83 per cent of 20-59 year-old women in the UK were being screened for cervical cancer on a three or five-yearly basis. However, in Ireland, only nine per cent of the population is covered by a population-based pilot cervical screening project in one health board area.
Researchers found that, since 1988, deaths from cervical cancer in England and Wales dropped by five per cent each year and, in Scotland, by four per cent each year. Northern Ireland also saw a two per cent drop in deaths per year. However, the Republic of Ireland has seen a steady increase of 1.5 per cent every year since 1978.
Dr Anna Gavin, Director of the Northern Ireland Cancer Registry, says: “These results show that the number of deaths from cervical cancer is increasing only in Ireland.
“Some subtypes of the human papilloma virus, which is sexually transmitted, can trigger cervical cancer. The UK and Ireland have both seen increases in sexually transmitted diseases since the 1970s. This caused a corresponding increase in cervical cancer incidence and mortality in Ireland but not in the UK. It’s pretty clear that the introduction of the national screening programme stopped cases of cervical cancer and deaths increasing in the UK.”
Dr Harry Comber, Director of the National Cancer Registry, Republic of Ireland, says: “The results mirror what happened in the Nordic countries in the 1960s and 1970s, when cervical cancer death rates decreased sharply in countries that introduced screening. Norway’s deaths from cervical cancer continued to increase until they introduced a screening programme.”
Dr Lesley Walker, Director of Cancer Information at Cancer Research UK, who own the British Journal of Cancer, says: “Pre-cancerous changes in the cervix caused by HPV infection do not cause any symptoms, which is why it is so important to have regular screening. A population based screening programme for cervical cancer must be introduced in Ireland to reduce cases of the disease and save lives.
“The British cervical screening programme has been remarkably successful at reducing the number of cases and deaths from the disease. Overall, cervical cancer rates in the UK have halved since the national screening programme was introduced.
“This new study adds to the volume of work that shows how effective national screening programmes have been and continue to be in the detection and consequent early treatment of cancer.”
- British Journal of Cancer91 (11) Read the report
Ireland is used interchangeably with Republic of Ireland. Note Northern Ireland is not included in ‘Ireland’ in this context.
The Irish Cervical Screening Programme offers free cervical screening to women aged 25-60 years in the Mid-Western Health Board (MWHB) area of Ireland. Women aged 25-60 years in this area are invited to attend regular screening over a five-year period.
In 2000 the incidence rate for cervical cancer was 10.5 cases per 100,000 women in the Republic of Ireland and 8.9 cases per 100,000 women in the UK.
In 2000 the mortality rate for cervical cancer was 3.6 deaths per 100,000 women in the Republic of Ireland and 3.3 deaths per 100,000 women in the UK.
In the UK around 3,000 new cases of cervical cancer are diagnosed and 1500 women die from cervical cancer every year. It can affect women of any age who are, or once were, sexually active. Cervical screening saves over1000 lives in the UK every year.
Scientists have linked nearly all cases of cervical cancer to subtypes of the human papilloma virus or HPV. Most sexually active women will be infected with HPV at some point as it is very common but the virus usually clears up on its own.
If HPV persists it can lead to changes in the cells of the cervix, which may lead to cancer if left untreated. Cervical screening detects these early changes and the abnormal cells can be removed thereby preventing cancer developing.
Cervical cancer is one of the few cancers that are preventable because pre-cancerous cell changes can be picked up in a screening test.
What is cervical screening?
A nurse or doctor takes a small sample of cells from the surface of your cervix and spreads them onto a glass slide. This is called a cervical or PAP smear. When it reaches the lab, the slide is treated and then put under a microscope. The cells are examined and any abnormal ones reported.
This is a test for pre-cancer. A positive smear does not mean you have cancer. It means you have cells that, if untreated, might go on to develop into cancer.
The cervical smear test
A scraping of cells is taken from the surface of the cervix and examined under the microscope to see if any of them are showing signs of becoming cancerous.
Symptoms of cervical cancer
The most common symptom of cervical cancer is bleeding from the vagina at other times than when you are having a period. You may have bleeding:
- Between periods
- After or during sex
- At any time if you are past your menopause
Some women also have:
- A vaginal discharge that smells unpleasant
- Discomfort or pain during sex (doctors call pain related to sex ‘dyspareunia’)
There are many other conditions that cause these symptoms. Most of these conditions are much more common than cervical cancer, but it is very important to get your symptoms checked out by a doctor. If it does turn out that your symptoms are caused by cervical cancer, the sooner you are treated the more likely you are to be cured and usually the less treatment you will need to have.