The launch yesterday of a National Screening Programme for Cervical Cancer is an important element of the National Cancer Strategy.
The programme, which is being rolled out on a phased basis, will initially target the 67,000 women aged 25 to 60 who live in the Mid Western Health Board region. All those in the target group will be invited to attend their doctor, family planning clinic or public health nurse for a free smear test.
There were 160 cases of invasive or established cervical cancer diagnosed in 1997 and 800 cases of carcinoma in situ or precancer were identified nationally in the same year.
The screening involves taking a smear from the cervix and sending it to a laboratory for examination. Changes in the cervical cells are graded according to the degree of distortion. Most importantly, it is possible to identify pre-cancerous lesions called cervical intraepithelial neoplasms (CIN) which can be successfully treated in an outpatient setting using a laser-like device.
Dr Mairead Griffin, president of the Irish Association of Clinical Cytology, told The Irish Times yesterday that new technologies will change testing for the first time since Papanicolaou pioneered the cervical smear test 60 years ago.
Cervical cancer is usually slow growing, taking between three and 10 years to develop into a full-blown cancer. Some low-grade lesions regress spontaneously; however, in a small number of younger women, a particularly aggressive form of tumour is seen. Current thinking suggests the presence of the human papilloma virus (HPV) may cause the cervical changes to become especially aggressive.
Risk factors for cervical cancer, apart from the presence of HPV, include early sexual activity and smoking.
A screening programme in the UK has seen cervical cancer fall by 42 per cent in 10 years. To achieve these successful rates, the uptake of screening will have to be at least 80 per cent, with a screening frequency of three to five years.
Cervical smear-testing is not an absolute science. False negative rates of between 5 and 15 per cent have been reported. A false negative test means that a woman could be told she has a normal cervix, when in fact pre-cancerous changes are present. Because of the frequency of testing and the slow-growing nature of the disease, these false negatives are usually detected before they become invasive.
Information leaflets on the programme are available from clinics and doctors' surgeries in the mid-west. Women who want to check if they are on the screening register can call a helpline on 1850 252600. Further information is also available from the programme website at www.icsp.ie