Research from Trinity College Dublin estimates that since CervicalCheck - Ireland’s free national cervical screening programme - began, over 5,500 cervical cancers have been prevented.
That means cancers that might have developed never got the chance to start.
So how does that happen in practice?
Let’s talk about how cervical screening, follow-up tests and treatment work together to prevent cervical cancer.
Let’s start with the cervix
The cervix is the lower, narrow part of the womb (uterus). It connects the womb to the vagina.
The cervix is made up of two main types of cells:
- Squamous cells – flat cells on the outside of the cervix
- Glandular cells – cells on the inside of the cervix.
These two types of cells meet in an area called the Transformation Zone. This is a normal part of the cervix. It’s also the place where most cell changes happen in the cervix. And where most cervical cancers start.
This is why cervical screening focuses on this area.
The link between HPV and cervical cancer
Most cases of cervical cancer are caused by HPV – the human papillomavirus.
HPV is a common virus which most of us will get at some point in our lives. In many cases, the body clears HPV on its own.
But sometimes HPV stays in the body. This is called ‘persistent HPV’. Over time, it can cause changes to cells in the cervix - abnormal cell changes - which can develop into cervical cancer.
We know from research that HPV causes more than 90% of all cases of cervical cancers. It causes about 99% of squamous cell cancers, the most common type.
Prevention – a key aim of cervical screening
Cervical screening can help to find cervical cancer at an early stage. But it’s not just about this.
One of the main aims of cervical screening is to prevent cervical cancer altogether by:
- finding HPV
- finding abnormal cells caused by HPV
- treating those abnormal cells before cancer develops.
Why we test for HPV first
CervicalCheck uses HPV primary screening. This means your sample is tested first for HPV. This helps us to find out who is at risk of changes to the cells in the cervix.
If HPV is not found, your risk of cervical cancer is low and you return to routine screening.
If HPV is found, the same sample is checked for abnormal cell changes. This helps to decide what happens next.
When abnormal cells are found
If your screening test shows HPV and abnormal cells, you may be referred for a colposcopy.
A colposcopy is an examination to take a closer look at your cervix. It takes place in a hospital outpatient clinic and is free through the CervicalCheck programme.
At colposcopy:
- a specialist examines your cervix
- small biopsies may be taken
- treatment may be offered if needed.
How treatment at colposcopy prevents cancer
At colposcopy, some women will need treatment to remove abnormal cells from the cervix.
This is pre-cancer treatment.
The most common pre-cancer treatments at colposcopy are:
- Thermal ablation, also called cold coagulation
- LLETZ (large loop excision of the Transformation Zone.
This treatment removes the abnormal cells to stop them from developing into cancer.
This treatment works because:
- abnormal cells can take years to turn into cancer (15 to 20 years)
- removing them early breaks that process
- cancer never gets the chance to develop.
Follow-up after screening really matters
If you are advised after your cervical screening to attend colposcopy for follow-up tests or treatment, it is important to go, because:
- follow-up care completes the prevention process
- it ensures abnormal cells are treated
- it protects your long-term health.
Going for follow-up tests and treatment when you’re advised is one of the most effective ways to prevent cervical cancer.
HPV vaccination and screening – working together
Prevention of cervical cancer doesn’t start with screening alone – it starts with the HPV vaccine.
The HPV vaccine protects against the main types of HPV that cause most cases of cervical cancer. It’s our first line of protection against cervical cancer and research shows it greatly reduces serious pre-cancer changes.
Screening adds another layer of protection:
- It finds HPV infections that persist.
- It detects cell changes early.
- It leads to treatment before cancer starts.
Even if you’ve had the HPV vaccine, you should still go for cervical screening every time you’re invited. The vaccine protects against the main types of HPV that cause cervical cancer but does not protect against every type of the virus.
Ireland’s plan to make cervical cancer rare
Together, vaccination, screening and treatment are preventing more cervical cancers every year.
Ireland has a clear action plan to eliminate cervical cancer and make it rare by 2040.
Treatment of pre-cancer is a vital part of this plan:
- to prevent cervical cancer before it starts
- to reduce future illness and deaths
- to protect women across every community.
Protect your future health
- Choose the HPV vaccine when it’s offered.
- Go for cervical screening every time you’re invited from the ages of 25 to 65.
- Attend follow-up tests and treatment when advised.
- Talk about cervical cancer prevention with family and friends.
Cervical cancer is one of the most preventable cancers. Treatment of abnormal cells is a powerful part of preventing it.
Together, we can stop cervical cancer before it starts.
- Following a move to Ireland in 2020, Alejandra Diaz, aged 30, from Mexico, registered with a local GP practice and attended her first HPV cervical screening in 2022. Her results indicated that she had HPV and abnormal cells had been found in her screening sample. Alejandra followed up with an appointment in colposcopy to have the abnormal cells removed, helping to stop cervical cancer before it had a chance to develop. Read Alejandra’s story.