Cervical cancer death highlights importance of seeking specialist referral for symptoms and of HPV vaccination
The recent death of a 19 year old woman in the UK from cervical cancer has prompted Jersey’s gynaecology consultants to urge women to seek immediate referral to the hospital if they experience symptoms.
Two weeks ago, national newspapers carried reports about Sophie Jones, an aspiring model from Liverpool, who died of cervical cancer. Dr Fiona Nelson, consultant gynaecologist, explained that cervical cancer is very rare amongst young women, however she says young women need to be aware of symptoms that should prompt them to request an urgent referral to the gynaecology clinic at the Hospital.
- abnormal bleeding between periods
- bleeding after sex
- an abnormal discharge
- pain during intercourse
Dr Nelson added “In the case of the 19 year old who died recently from cervical cancer, it seems this girl did indeed have symptoms but does not appear to have been referred to local gynaecology specialists. There was some commentary that she should have had a screening (smear) test but this would have been the wrong approach when there are symptoms”.
Dr Nelson explained “Doctors in the UK and in Jersey are correctly taught that a cervical smear is not the answer if a woman has symptoms but that urgent referral to hospital is paramount. This is because the smear test is not a diagnostic test for cancer nor is it a perfect test – for example, a smear test performed on a woman experiencing symptoms could show a negative result even though cancer or some other condition may be present. This may falsely reassure the woman and her doctor that all is well, when in fact what any woman who is experiencing symptoms needs is urgent gynaecological referral to hospital for investigation.
“The smear test looks for cervical cell changes in women with no symptoms. In women aged under 30, these changes happen frequently but tend to go away of their own accord. Cell changes are particularly common in women aged under 25. This is because it is at these young ages when women tend to have most exposure to the Human Papillomavirus (HPV).
“Some countries start screening at age 30, but accumulating international evidence now tells us that age 25 is the optimal age to start screening, for maximum detection of cell changes that may develop into cancer whilst minimising unnecessary treatment of younger women.
To carry out smear tests and treat cell changes in women under 25 risks damage to the cervix, which in turn can lead to women having late miscarriages in the future, also to premature deliveries with the risk of babies dying or having disabilities if they are born very early”.
Parents of girls in Jersey are also being reminded of the importance of the HPV vaccine for their daughters. Dr Linda Diggle, head of healthcare programmes at Jersey’s Public Health department said: “This tragic case highlights the importance of the HPV vaccine which prevents over 70% of all cervical cancers. We would encourage all girls to have the vaccine when it is offered.
“Since 2008, in Jersey and in the UK, girls have been, and continue to be, offered the HPV vaccination when they are age 12/13. Provided the vaccination course is given before girls become sexually active, this course of injections will protect them against HPV types that cause the vast majority of cervical cancer cases. This year, in Jersey, 93 per cent of girls in school year 8 took up the HPV vaccine and we’d like that figure to be even higher. This publicly funded vaccine programme is offered at this age as the evidence tells us this is the correct time to deliver this protection”.
Dr Diggle said: “Cervical cancer is not hereditary. We know it is caused by HPV infection and that HPV infection in women is part and parcel of normal life and relationships. HPV infection and the resulting cell changes tend to regress in young women – that is, the infection and the abnormalities tend to disappear on their own. But sadly, this doesn’t always happen and very rarely cases of cervical cancer can occur, sometimes developing very fast. We advise parents that encouraging their daughter to have the vaccine at age 12/13 is one of the most important things they can do to protect her in the future.”