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Should I see a cervical cancer specialist?

Women discussing cervical cancer

This page tells you about the guidelines that GPs have, to help them decide who needs to see a specialist for possible cervical cancer. There are sections on

 

A quick guide to what's on this page

Should I see a cervical cancer specialist?

It can be very difficult for GPs to decide who may have a suspected cancer and who may have something much less serious. There are guidelines for GPs to help them decide which patients need to see a specialist urgently.

What your GP should do first

Your GP should examine you internally if you have a change in your menstrual cycle, bleeding after sex, bleeding if you are past your menopause, or an abnormal discharge from your vagina. The GP should do a full internal examination of your vagina, using a speculum so that they can see the cervix properly.

Guidelines for urgent referral

You should ideally get an appointment within 2 weeks for an urgent referral. The symptoms that need urgent referral for possible cancer of the cervix are

  • Any sign of cancer of the cervix your GP can see from an internal examination
  • Heavy bleeding after the menopause in women not on hormone replacement therapy (HRT)
  • Bleeding that is persistent or unexplained after stopping HRT for 6 weeks
  • Repeated bleeding after sex or between periods for no apparent reason

If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment.
 

CR PDF Icon You can view and print the quick guides for all the pages in the about cervical cancer section.

 

 

About these guidelines

It can be very difficult for GPs to decide who may have a suspected cancer, and who may have something much less serious that will go away on its own. With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment (such as antibiotics). If GPs referred everyone they saw to a specialist immediately, the system would get jammed and those needing urgent appointments wouldn't be able to get them.

There are particular symptoms that mean your GP should refer you to a specialist straight away. The National Institute for Health and Clinical Excellence (NICE) and the Scottish Government have produced guidelines for GPs to help them decide which patients need to see a specialist urgently.

 

What your GP should do first

The guidelines say your GP should examine you internally if you have

  • A change in your menstrual cycle
  • Bleeding after sex
  • Bleeding if you are past your menopause
  • An abnormal discharge from your vagina

The GP should do a full internal examination of your vagina, using a speculum so that they can see the cervix properly. Most of these symptoms are related to abnormal bleeding. This is the most common symptom of cervical cancer. Bleeding is considered abnormal if you have it

  • Between periods
  • After or during sex
  • At any time if you are past your menopause

The NHS Cervical Screening Programme aims to pick up and give treatment for abnormal cervical smears before they develop into cancer. Screening detects about 40 out of every 100 women (40%) diagnosed with cervical cancer.

Scottish guidelines for cervical cancer state that if you have not yet had your menopause, and you have any of the above symptoms, or your cervix is inflamed or bleeding on contact, then you should be tested first to see if you have Chlamydia. Chlamydia is a sexually transmitted infection which can cause some of the same symptoms. If you are past your menopause and you have bleeding, your GP should do an internal pelvic examination. Post menopausal bleeding can also be a symptom of womb cancer.

 

Guidelines for urgent referral

According to Department of Health guidelines, you should ideally get an appointment within 2 weeks for an urgent referral. The symptoms that need urgent referral to a specialist for possible cancer of the cervix are

  • Any visible sign of cancer of the cervix that your GP sees when examining you internally
  • One or more episodes of heavy bleeding from the vagina after the menopause in women who are not on hormone replacement therapy (HRT)
  • Bleeding that is persistent or unexplained after stopping HRT for 6 weeks or more
  • Repeated bleeding after sex for no apparent reason
  • Repeated bleeding between periods for no apparent reason

The guidelines make it clear that you should have a specialist referral with these symptoms, not just a smear test. They also say that an earlier negative smear is not a good reason for delaying a referral if you have signs of cervical cancer.

If your GP can feel a lump in your lower tummy (pelvis), and it doesn't feel like fibroids, they can decide to refer you for an urgent ultrasound scan. If an urgent scan is not available, they should refer you straight to a specialist.

 

If you are still worried

If you are concerned that your GP is not taking your symptoms as seriously as you think he or she should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you and then you may be able to decide together whether you need to see a specialist and if so, how soon.

 

What happens when you see a specialist

If you see a specialist they will want to examine you and may do several tests. There is information about the type of tests that you may need in the diagnosing cervical cancer section.

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Updated: 16 August 2012