Self-Swabbing Vs In-Person Smear Test: What's your choice?
Gynaecological cancers refer to the cancers that affect the female reproductive system such as the ovaries, uterus, cervix, fallopian tubes, vulva, and vagina. According to Eve Appeal, which is the U.K’s Gynaecological Cancer Research Charity, that raises awareness and funds research into the five common gynaecological cancers: Womb, Ovarian, Cervical, Vulval and Vaginal, there are over twenty two thousand new cases of gynaecological cancer every year in the U.K. Symptoms of gynaecological cancers may include pelvic and abdominal pain, bloating, abnormal vaginal bleeding, and changes in bowel habits. Early detection and treatment are crucial for the successful management of these cancers. Regular gynaecological screenings, including Pap tests and pelvic exams, can help detect these cancers in the early stages. Understanding the risks and symptoms associated with gynaecological cancers is important for all women to help prevent and manage these potentially life-threatening conditions.
Cervical screening, also known as a smear test, is an important preventative healthcare measure for women. The test involves taking a small sample of cells from the cervix to check for any abnormalities that could lead to cervical cancer. It is recommended that women aged between 25 and 64 years old should have a cervical screening every three to five years, depending on previous results, and those who are living with HIV should have one every year. Early detection of abnormal cells can lead to prompt treatment and a higher chance of successful outcomes. It is a simple and relatively quick procedure that can help to save lives, so it is important for all eligible women to participate in regular cervical screening.
Women in a park
There are two main types of cervical screening tests: the Pap test and the HPV test. The traditional Pap test involves collecting cells from the cervix and examining them under a microscope for any abnormal cells. This test can detect early signs of cervical cancer and is typically recommended for women aged 21 to 65. On the other hand, the HPV test checks for the presence of the human papillomavirus (HPV), which is the main cause of cervical cancer. This test can be done alone or in conjunction with a Pap test and is typically recommended for women aged 30 or older. It's important for women to discuss with their healthcare provider which type of screening is best for them and how often they should be screened.
Self swabbing tests have recently been introduced to allow women who would otherwise be uncomfortable with in-person tests or do not have time to attend in-person screening appointments. The self swabbing smear test is a much more convenient way to get checked for cervical cancer. Going for an in person smear test can be a daunting experience for some women. However, the self swabbing test can be done comfortably at home by following the instructions carefully. It also saves time and eliminates the need to visit a healthcare facility. On the other hand, an in person smear test is still necessary for some women, particularly those who may require additional medical attention or have difficulty performing the self swabbing test. Despite the slightly invasive nature of in person tests, they remain an essential part of women's health care, and they should never be ignored.
While i am all in favour of Self Swabbing for all the reasons listed above plus that it provides some sort of screening for those women who would have fallen through the cracks, i am still a firm believer in in-person smear tests because of the extra level of safety net it provides. Let me explain!
Woman sitting on couch
When i attend my smear test appointment ( which takes weeks of me psyching myself up), the nurse has a general conversation with me about how i am doing and if there have been any changes since my last smear test. Once i am lying down and in position and comfortable, she checks my vulva area for any changes, then feels for any swollen glands and once she is satisfied that everything looks healthy and alright, she inserts the speculum and continues with the smear test. Once all is done, i leave the appointment reassured that whilst i wait for my results, i am relaxed in the knowledge that my pelvic exam was otherwise normal and that i have no signs or symptoms of vulval cancer. But while in-person smear testing is my preferred choice of testing, i will leave you with the Pro and Cons of both, so that you can decide which one you would prefer, if not both.
Pros and Cons of Self-Swabbing Smear Test
Self-swabbing smear test is becoming more common as an alternative to the traditional method. There are pros and cons to consider when deciding whether to go for self-swabbing or not.
# Pros:
1. Less invasive - Self-swabbing test is less invasive because women do not require insertion of the speculum. This makes the procedure more comfortable for some women.
2. More privacy - Self-swabbing smear test allows women to perform the test in the privacy of their own homes. This enables women who find the traditional smear test embarrassing to have the test without feeling embarrassed.
3. Convenient - Women do not need to book an appointment or visit a clinic for a self-swabbing smear test. The self-swab can be done at home at a convenient time.
4. Cost-effective - Self-swabbing smear tests are usually cheaper than the traditional smear tests performed by medical professionals. This makes it a more affordable option for women who may not be able to afford the regular smear test fees.
# Cons:
1. Potential for inaccurate results - Self-swabbing may not be as accurate as the traditional smear test because the sample could be contaminated or insufficient,
Pros and Cons of In-person Smear Test
# Pros
Accuracy: In-person smear tests are generally more accurate than at-home tests.
Thoroughness: A healthcare professional can perform a more thorough exam during an in-person smear test.
Immediate Results: Depending on the facility, results can be available immediately after the test is performed.
Availability of Follow-up Care: If any abnormalities are detected, the healthcare professional can offer follow-up care or referrals for treatment.
Experienced Medical Professionals: The healthcare professional performing the test has undergone training and has experience in performing smear tests.
# Cons
Discomfort and Pain: For some individuals, smear tests can be uncomfortable or even painful.
Embarrassment or Shame: There may be cultural or personal barriers that make the test cumbersome or shameful to undergo.
Time and Effort: An in-person smear test requires scheduling an appointment and taking time out of one's day to travel to the facility.
So whichever method you choose, just remember that early detection saves lives and it is important to have your screening done when invited to have one.
September is Gynaecological Awareness Month!
Raising awareness of Gynaecological Cancer.
According to a civil service blog on Gov.uk, there are more inequalities in Cancer morbidity and mortality amongst black women, despite equal access to the National health Service(NHS) .
Cervical cancer remains the commonest cancer amongst women under the age of 35 and posses a greater risk of death in Black Women over the age of 65 despite being preventable by upto 80% via screening according to studies done by Dr Ekechi, a London based Obstetrician and Gynaecologist, one on behalf of the Jo Cervical Cancer Trust. She also highlights the fact that deaths from endometrial cancer are highest in Black Women, a statistic also backed by a study by the in the American Journal of Obstetrics and Gynaecology who suggest that this is the case because Black Women are less likely than White Women to receive an early diagnosis!
So why are Black Women more likely to die from cancer? according to a study done by the Department of Obstetrics and Gynaecology at University of Washington, some of the reasons are:
the inability to get an early diagnosis
Doctors are more likely to view black patients as medically uncooperative and that diagnosis and treatment decisions are influenced by race.
Lack of confidence by Black Women in the healthcare system due to difficult episodes and not being believed when they present with symptoms
Below are links to articles and organisations like The Eve Appeal that aim to address these issues and raise awareness about cancer and the black woman.
1)BAME women are let down by the health system – nowhere more so than in gynaecological health: https://www.google.com/amp/s/inews.co.uk/opinion/comment/bame-women-are-let-down-by-the-health-system-nowhere-more-so-than-in-gynaecological-health-288985/amp
2) Breaking Down the Taboos: Lifting the Lid off Cancer in BAME Communities: https://civilservice.blog.gov.uk/2020/10/19/breaking-down-the-taboos-lifting-the-lid-off-cancer-in-bame-communities/
3) Ciara’s Mega Mission: Stopping Cervical Cancer In Black Women: https://www.forbes.com/sites/lipiroy/2021/07/02/ciaras-mega-mission-stopping-cervical-cancer-in-black-women/
4) Gynaecological Cancers: https://eveappeal.org.uk/gynaecological-cancers/
5) One Type of Cancer is Killing Black Women at Record-High Rates: https://obgyn.uw.edu/news/one-type-cancer-killing-black-women-record-high-rates