10 February 2009
Dr Susan Turnbull, Deputy Medical Officer of Health and Jersey’s Public Health Lead on Cancer and Screening, is delighted to report that, after its first year, the new system of screening women for cancer of the cervix – Liquid Based Cytology (LBC) – is meeting all of her and colleagues’ expectations.
The service improvement investment of £200,000 from Health and Social Services helped support the purchase of new laboratory equipment and has supported the training of laboratory staff including Cytotechnologists and the Consultant Cytopathologists. All ‘sample takers’ – including all GPs in the island – have also completed special training.
The two main advantages over the ‘old’ cervical smear method are:
- The LBC system is highly reliable with very few tests needing to be repeated –‘clear result first time’ 98 times out of 100 (the ‘old’ cervical smear method had a 12% ‘inadequate’ rate – so 12 in every 100 women who had a smear test needed to be called back for it to be repeated).
- 9 out of 10 women are now receiving their result in 2 weeks or less.
The woman’s experience of having an LBC test will be similar to a smear test – but many women are reporting that the new brush used is much more comfortable than the old wooden spatula. The difference is a new and improved way of sampling the cells from the cervix (neck of the womb), and how they are transferred to the laboratory and processed there. In the past with the smear test, a sample of cells from the surface of the cervix was applied to a glass slide using a spatula and examined under the microscope. LBC ‘sample takers’ use a special LBC brush and container to preserve and transfer the brush to the laboratory at Jersey General Hospital, where a series of 5 processes then prepare the sample by suspending the cells in a solution before its application to a glass slide. This allows an even spread of cells that can be seen more clearly under the microscope – compared with the old ‘smear’ method where sometimes the cells couldn’t be seen distinctly enough in the lab for judgement to be made if they looked normal – or not.
The Jersey Cervical Screening Programme exists to reduce the chances of women developing cancer of the cervix. Its main aim is to pick up changes in the cervical cells that could develop into cancer if left untreated – this cancer can be prevented. Treatment is simple and overall, very effective. We have a highly successful service, and now it is even better. All women between the ages of 20 and 65 years of age are invited to take part, and can choose to attend their own GP, or the clinic at Le Bas Centre. Once enrolled, they will be invited for a further routine test every three years.
In our first year of using LBC, 9,000 women participated in the screening programme. 62 of these women were identified as having serious pre-cancerous changes present in the cells and were referred for treatment. With a reduction in the ‘inadequate’ rate from 12 per 100 to 2 per100, a quick calculation indicates that 10 fewer women in every 100 will have needed to be called back for a repeat for this reason – out of the 9000 women tested last year, 900 fewer will have had the extra worry of an ‘inadequate’ result and the inconvenience of a second test. A further bonus has been that many fewer women have needed to be referred to hospital for colposcopy simply because of multiple inadequate samples. All this has led to greater efficiency in the system and a much reduced turnaround time.
Dr Turnbull commented: “This is a huge stride forward for Jersey and meets all our hopes and expectations. The human cost of the anxiety some women will have experienced, in the past, when their smear test needed to be repeated cannot be underestimated. More worryingly, it is possible this could have put some women off coming back regularly for their tests."
Senator Jim Perchard, Minister for Health and Social Services, said: “I congratulate my staff for bringing about this welcome improvement for women in Jersey. Despite the tough challenges of providing health care at a time when costs are increasing exponentially, it is great news that we are able to improve our effectiveness and efficiency in cervical cytology. I am very grateful to those highly motivated professionals who have made this advance possible."
Facts and figures:
Every year in Jersey, approximately 5 women (average figure, based on numbers of new cases between 2000-5) are diagnosed with cervical cancer. There are 1-2 deaths here every year due to this cancer. In the UK, about 1000 women die of this cancer every year. In most of these cases, the women have never had a cervical smear.
Colposcopy - a more detailed examination of the cervix, usually with biopsies (tissue samples) taken for analysis. Treatment of abnormal areas of the cervix can be performed during colposcopy. A colposcope is an optical instrument through which the cervix can be magnified and visualised in much greater detail than the naked eye.
gov.je