Cervical cancer kills 90 women in Ireland each year, that's almost two women a week.
Following the CervicalCheck scandal, much fear surrounds cervical screening.
Two out of three girls availed of the HPV vaccine when offered to them in school last year, but the Irish Cancer Society says uptake should be 100 per cent.
Ahead of International Women's Day, Louise from The Hub spoke to Dr Ciara Kelly to ask her about HPV, smear tests and cervical cancer.
Dr Kelly is a medical doctor and a health and wellness blogger at The Irish Balance.
The smear test: A doctor with a cervical sampleWhat is HPV?
"HPV stands for Human Papilloma Virus and it's a viral infection that's spread by direct contact, usually sexual contact, with a person that has that infection.
"About 80 per cent of all women in Ireland will contract HPV infection in their lifetime, that's usually in their late teens/early 20s by sexual contact.
"Most women will clear that HPV infection naturally but some high-risk HPV subtypes can potentially lead to cancerous changes in cervical cells.
"There's lots of different subtypes of HPV but two particular high-risk ones, 16 and 18, are estimated to cause about 70 per cent of cervical cancers, which are two subtypes the vaccine protects against."
Does HPV only cause cervical cancer?
"It isn't just a virus that affects women, it affects males and females.
"So, in addition to cervical cancer, HPV causes more than 90 per cent of anal cancers, almost 70 per cent of vaginal and vulvar cancers, over 50 per cent of penile cancers, and over 70 per cent of oropharyngeal cancers."
"And they're estimates from Irish data so you can see it really does cause a spectrum."
What is the HPV vaccine and who is it available to?
"So, many, many studies have established the robust safety and efficacy of the vaccine we use in our programme in Ireland, which is called Gardasil.
"And this is the vaccine used in the HSE's school vaccination programme, and it protects against those two high-risk subtypes I mentioned, 16 and 18, which cause about 70 per cent of cervical cancers; and then two HPV subtypes that cause 90 per cent of genital warts, which are 16 and 11.
"Ideally, it's to be given to young girls before exposure to HPV at first sexual contact, which is why it's recommended for girls aged 12 to 13.
"So, in Ireland, all girls in first year of secondary school are offered the HPV vaccine each year."
What's a smear test and when should you have a smear?
"A smear test is the screening method we use for our cervical screening programme in Ireland.
"A smear test basically aims to detect precancerous changes in the cells of a woman's cervix, and the cervix is the neck of the womb.
"Cervical cancer can take anything from 10 to 15 years to develop and it does make it a preventable disease if we can detect it early.
"In Ireland, all women aged 25 to 60 should be having their cervical screen when it's due, and they get sent a letter inviting them to attend for their smear.
"So, that's every three years if you're aged 25 to 44 and every five years from 45 to 60. And you should have your smear even if you've had the HPV vaccine.
"And it's also really important to remember that a cervical smear isn't a diagnostic test for cancer. It's carried out on women who are healthy, who don't have any symptoms, to try and detect any potential abnormal changes in the cervix that might be present."
What happens when you go for your smear test?
"I know there's a phrase 'fear the smear' and I think it's really, really common and that's very understandable.
"First of all, if you're very nervous about getting your first smear, don't be. It's really worth having a chat with your GP or practice nurse about it in advance, if you do have concerns.
"Or even chatting to a family member or friend who've had theirs and they might be able to allay those anxieties you might have.
"So, a doctor or trained nurse will perform the test and an instrument called a speculum is used; and that's used to open the vagina which allows the person performing the test to see the cervix, and they use a small specialised brush to get a sample of cells from the cervix.
"It can feel a little bit odd and some find it a little bit uncomfortable but not painful. And the more you try to be relaxed about it, the less uncomfortable it's going to be.
"It's a very, very quick test - usually less than five minutes."
When should you expect to receive the results of your smear?
"I can't give a definite, accurate answer on that because it's going to depend on the clinic and the waiting times at the moment.
"But what happens when the sample is taken, it's then sent off to a lab for review and then that result is sent back to your GP or the clinic you attended.
"According to the HSE website, it will be within 4 to 6 weeks but I think there's a bit of an extended wait time at the moment, so it's best to keep an eye on the HSE website to see what the current wait times are for results.
What happens if the results are abnormal?
"If there's any abnormal changes found on the smear, you get called back to your GP or the clinic to discuss them.
"The abnormal cell changes are something called CIN, or cervical intraepithelial neoplasia, and there's different stages of those.
"So, what may happen is that you might be referred on for another procedure called a colposcopy; and it's a free service, and it's quite a simple procedure that just looks at the cervix a little bit closer, to see if those abnormal changes are present and to see if any treatment might be needed.
"So if you get called back, don't panic and don't avoid that appointment out of fear."
What are the signs and symptoms of cervical cancer?
"Generally, cervical cancer affects women mostly between the ages of 30 to 45 who are sexually active.
"Symptoms to be aware of include irregular vaginal bleeding, or bleeding between periods, pain during sexual intercourse, or bleeding after sexual intercourse, and pain in the pelvis.
"So, if you do notice any of those symptoms, and even if you have had a recent normal smear, it is worth making an appointment with your GP just to get that checked out."
You can see if you're on the CervicalCheck register here.
You can listen to the full interview below.
