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  <p begin="00:06" end="00:10">I'm Richard Smith. I'm a consultant gynaecological surgeon</p> 
  <p begin="00:10" end="00:14">at the West London Gynaecological Cancer Centre which is part of Imperial College.</p> 
  <p begin="00:14" end="00:19">Cervical screening is where women go to their doctor to have a smear done</p> 
  <p begin="00:19" end="00:24">and the purpose of taking smears is to detect CIN 2 and 3</p> 
  <p begin="00:24" end="00:28">and if you treat those conditions, then you virtually one hundred percent of the time</p> 
  <p begin="00:28" end="00:30">will prevent people getting cancer.</p> 
  <p begin="00:30" end="00:34">90 percent of people who have a smear will find that it is a normal smear</p> 
  <p begin="00:34" end="00:38">and in a woman's lifetime, ten percent of all women will get an abnormal smear.</p> 
  <p begin="00:38" end="00:43">How many of those will get a high grade legion? Meaning CIN 2 or 3,</p> 
  <p begin="00:43" end="00:46">then you are down to one to two percent.</p> 
  <p begin="00:46" end="00:50">How many people will actually have cervical cancer, detected from a smear?</p> 
  <p begin="00:50" end="00:53">Way less than one percent.</p> 
  <p begin="00:53" end="00:57">So although most women going for that smear believe that it's been done to detect cancer,</p> 
  <p begin="00:57" end="01:00">it is not, and it very, very rarely ever does detect cancer.</p> 
  <p begin="01:00" end="01:06">Usually we don't treat CIN 1 at the first diagnosis. It has to be there for at least 6 months.</p> 
  <p begin="01:06" end="01:11">And if you've got borderline then you're unlikely to get any treatment at all.</p> 
  <p begin="01:11" end="01:18">The success of the treatment is very very high. 95 to 98 percent, at the first treatment</p> 
  <p begin="01:18" end="01:24">And if it fails, so if you're unlucky to be in the two to five percent, then the second treatment,</p> 
  <p begin="01:24" end="01:29">because you have the same treatment again, has got the same efficacy the second time round.</p> 
  <p begin="01:29" end="01:35">The chances of you actually getting through that net and getting cervical cancer is incredibly low.</p> 
  <p begin="01:35" end="01:40">The important thing to say is for cervical pre-cancer, there are no symptoms.</p> 
  <p begin="01:40" end="01:43">so there is no discharge, no bleeding, no pain, nothing.</p> 
  <p begin="01:43" end="01:46">Now, for cervical cancer that's different</p> 
  <p begin="01:46" end="01:49">and the signs there, are people can get pain</p> 
  <p begin="01:49" end="01:52">but more often their sign is that they're getting bleeding between their periods</p> 
  <p begin="01:52" end="01:55">or more pertinently bleeding after intercourse.</p> 
  <p begin="01:55" end="02:01">Of course it's really important to say that in the vast majority of people who have those symptoms do not have cervical cancer,</p> 
  <p begin="02:01" end="02:03">but those are symptoms of cervical cancer.</p> 
  <p begin="02:05" end="02:09">You may well come across the term HPV</p> 
  <p begin="02:09" end="02:12">and HPV stands for human papilloma virus.</p> 
  <p begin="02:12" end="02:16">Now that gets colloquially referred to as 'wart virus', which is a bad term</p> 
  <p begin="02:16" end="02:21">because the types of human papilloma virus which cause cervical pre-cancer,</p> 
  <p begin="02:21" end="02:26">and can lead on to cervical cancer, do not cause warts.</p> 
  <p begin="02:26" end="02:34">Up to 85 percent of all men and women will get infected with human papilloma virus at some point in their lives,</p> 
  <p begin="02:34" end="02:41">but the vast majority of people will get rid of the human papilloma virus without ever getting an abnormal smear.</p> 
  <p begin="02:41" end="02:47">90 percent of them will get rid of it without having any cervical pre-cancer or cervical cancer.</p> 
  <p begin="02:47" end="02:51">The other thing which is very contentious about human papilloma virus is</p> 
  <p begin="02:51" end="02:54">a lot of people think that it's a sexually transmitted infection</p> 
  <p begin="02:54" end="02:58">and therefore somehow implies infidelity on either their part,</p> 
  <p begin="02:58" end="03:01">or their partner's part, and that is not true.</p> 
  <p begin="03:01" end="03:09">So the HPV vaccine has been developed because we know that HPV is found within cervical tumours.</p> 
  <p begin="03:09" end="03:15">And this vaccine has been well tried, well tested and is at the moment,</p> 
  <p begin="03:15" end="03:22">in the United Kingdom, being given to girls who are 12 to 15 years of age, and there is a catch up programme to aged 18.</p> 
  <p begin="03:22" end="03:26">It's highly effective against two types of HPV, 16 and 18,</p> 
  <p begin="03:26" end="03:30">and they account for 70 percent of all the cases of cervical cancer.</p> 
  <p begin="03:30" end="03:34">Now of course that leaves 30 percent which are not covered by the vaccine,</p> 
  <p begin="03:34" end="03:38">which is why even if you've had the vaccine, you must still go to have smears.</p> 
  <p begin="03:39" end="03:43">The success of the smear programme is so obvious to somebody in my position</p> 
  <p begin="03:43" end="03:47">because we're actually doing very few operations these days for cervical cancer</p> 
  <p begin="03:47" end="03:53">and that is a testimony to the success of this programme and the fact that the vast majority of the population</p> 
  <p begin="03:53" end="03:56">go for smears and go for those smears regularly, it's really important</p> 
  <p begin="03:56" end="04:00">and is making the big difference in reducing the rate of cervix cancer.</p> 
  <p begin="04:02" end="04:05">[New speaker] For information, help, or if you just want a chat,</p> 
  <p begin="04:05" end="04:14">call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.co.uk</p> 
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