What Is Cervical Cancer?

Cervical cancer develops in the cells of the cervix — the lower part of the uterus that connects to the vagina. It does not usually develop suddenly. In most cases, it begins with subtle cellular changes known as cervical intraepithelial neoplasia (CIN), which may take years to progress.

Because these changes occur gradually, screening is extremely effective at detecting abnormalities early. When caught at a pre-cancerous stage, treatment is straightforward, and outcomes are excellent.

According to NHS England and data from Cancer Research UK, survival rates are significantly higher when cervical abnormalities are detected early. This is why screening remains one of the most important preventive health measures available to women.

For national guidance, see:

• https://www.nhs.uk/conditions/cervical-screening/

• https://www.cancerresearchuk.org/about-cancer/cervical-cancer

How Common Is Cervical Cancer in the UK?

Cervical cancer affects nearly 3,000 women each year in the UK. Thanks to the national screening programme, incidence and mortality rates have fallen significantly over recent decades.

However, screening uptake has declined in younger women, and delayed testing remains one of the key risk factors for diagnosis at a later stage.

Cervical cancer most commonly affects women aged 30–45, but the virus responsible for most cases — human papillomavirus (HPV) — is usually acquired much earlier.

The Role of HPV in Cervical Cancer

Human Papillomavirus (HPV) is a very common sexually transmitted infection. Most sexually active people will contract HPV at some stage in their lives.

High-risk strains of HPV are responsible for the vast majority of cervical cancer cases. HPV DNA is detected in approximately 90% of cervical cancers. The two most aggressive strains are:

• HPV 16

• HPV 18

These strains are strongly associated with high-grade cellular changes and cancer development.

It is important to understand that:

• Most HPV infections clear naturally within 1–2 years.

• Persistent infection with high-risk strains increases the likelihood of cellular changes.

• You can carry HPV for many years while having completely normal smear results.

This final point is crucial. A normal smear does not necessarily mean HPV is absent. This is why HPV testing plays such an important role in proactive screening.

For further scientific guidance, see:

• https://www.nice.org.uk/guidance

• https://www.gov.uk/government/organisations/uk-health-security-agency

NHS Screening Programme – What It Covers

The NHS Cervical Screening Programme is highly effective. Currently:

• Women aged 25–49 are invited every 3 years.

• Women aged 50–64 are invited every 5 years.

While this programme has saved thousands of lives, there are limitations:

• Screening begins at age 25.

• Testing intervals may be several years apart.

• HPV testing is integrated within screening but not routinely offered independently for younger women under 25.

In private practice, I often see sexually active women under 25 who wish to understand their HPV status earlier. Many feel reassured by more personalised monitoring.

Why I Recommend HPV Testing From Age 18

In my clinical practice, I recommend HPV testing for sexually active women from the age of 18, particularly if they have:

• Multiple partners

• Early onset of sexual activity

• A history of abnormal smears

• Concerns about exposure risk

HPV testing allows us to identify high-risk viral strains before cellular changes occur. If high-risk strains such as HPV 16 or 18 are detected, I recommend annual screening rather than waiting the standard three years.

This approach allows:

• Earlier detection of abnormal cell changes

• Closer monitoring of persistent infection

• Faster referral if needed

It is important to emphasise that testing positive for HPV does not mean you will develop cancer. It simply allows us to monitor you more closely and intervene early if necessary.

Risk Factors for Cervical Cancer

While HPV is the central cause, other factors influence progression from infection to cancer.

These include:

• Smoking

• Early sexual activity

• Multiple sexual partners

• Long-term combined oral contraceptive use

• A weakened immune system

Smoking in particular reduces the immune system’s ability to clear HPV, increasing persistence of infection.

Symptoms That Should Never Be Ignored

Early cervical cancer often causes no symptoms, which is why screening is so important. However, symptoms that require urgent assessment include:

• Vaginal bleeding between periods

• Bleeding during or after sex

• Bleeding after menopause

• Unusual or unpleasant vaginal discharge

• Discomfort or pain during intercourse

Any of these symptoms warrants prompt medical evaluation, even if your last smear was normal.

Understanding Smear Results & Cell Changes

If a smear detects abnormal cells, the changes are graded according to severity. These may be described as:

• Borderline changes

• Low-grade changes

• Moderate or severe changes

Most low-grade abnormalities resolve naturally. Higher-grade changes may require colposcopy (a closer examination of the cervix) and sometimes minor treatment to remove abnormal cells.

The purpose of screening is to detect these changes long before cancer develops.

How Cervical Cancer Develops

The progression from HPV infection to cervical cancer typically follows this pathway:

1. Exposure to high-risk HPV

2. Persistent infection

3. Development of pre-cancerous cellular abnormalities

4. Gradual progression to invasive cancer over several years

This timeline provides a valuable window for intervention. With appropriate monitoring, cervical cancer is largely preventable.

Reducing Your Risk

There are several evidence-based strategies that significantly reduce risk:

• Regular cervical screening and HPV testing

• HPV vaccination

• Condom use to reduce viral transmission

Condoms do not provide complete protection against HPV, but they reduce the risk of transmission. Vaccination offers protection against the nine most common high-risk HPV strains.

Cervical Cancer Prevention & Vaccination

The HPV vaccine is one of the most effective cancer-prevention tools available. In the UK, it is routinely offered to adolescents, but it can also be given later in life.

The current vaccine protects against nine HPV strains, including 16 and 18 — the two most aggressive types.

Vaccination does not eliminate the need for screening. However, combined vaccination and screening provide the highest level of protection.

Further information is available from:

• https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/

• https://www.rcog.org.uk/

When to Book Screening

You should consider booking cervical screening or HPV testing if:

• You are sexually active and under 25

• You have new or multiple partners

• You have previously tested positive for HPV

• You have symptoms such as abnormal bleeding

• You simply want reassurance

Early detection saves lives. In my practice, women’s health screening is discreet, professional, and focused on prevention rather than reaction.

Cervical cancer is one of the few cancers we can reliably prevent. With appropriate HPV testing, regular screening, and vaccination, the risk can be dramatically reduced.

If you would like personalised advice or wish to arrange cervical screening or HPV testing in Canary Wharf, we are here to help.