A) The smears are a scraping of the surface cells, and when placed in a special fluid they can be analysed and cancer cells detected. Smear tests are essential if you want to prevent cancer or catch a cancer early. Not having a smear because you are scared of what you might find makes no sense. Some of the tragedies that we see involve women who have never had smears and present when it's just too late to do anything about it.

Q) What is cervical cancer?

A) Cancer of the cervix is where the cells that line the area of the opening of the uterus or womb lose their normal control mechanism that keeps them from being over-produced or growing deeper into the tissues.

Cervical cancer spreads into the tissues around the cervix, which include the tubes from the kidney to the bladder. Blocking these will result in kidney failure and coma.

Q) What is the difference between abnormal cells and cancer?

A) The difference between pre-cancer and cancer is that pre-cancer has not invaded into the skin lining the neck of the womb deeply.

The cells involved are often the same. Where there is pre-cancer, the condition can be cured. Early cancer can also be cured, and sometimes without resorting to drastic surgery such as hysterectomy. The trick is to catch it early, hence the need for regular smears.

Q) How do you treat people with abnormal cells?

A) Until last year we treated all women using a wire loop that burns through the tissues with electricity to remove the abnormal area.

We could then perform an assessment and treatment all in one visit. However, we were overtreating a proportion of women, as some forms do not need active intervention as it will often get better with the body's own defences.

Also, the loop procedure is associated with a small increased risk of miscarriage and premature labour, and should be avoided where possible.

Now we can use the loop procedure for women who have completed their family. The other methods include cautery - this can only be done where we have a diagnosis from a small biopsy and requires two visits. It is thought to cause less damage to the cervix.

Q) How do you treat women with cancer?

A) Cancer can be treated by local excision, sometimes using the wire loop as described above if it is caught in the early stages.

Local excision saves the uterus for having children in women who are young and have not yet had children.

More advanced cancers may require a hysterectomy. This can be combined with radiotherapy if the nodes are positive or it is an aggressive tumour.

Where the cancer is too advanced, radiotherapy alone can be used.

Q) How many women were diagnosed with cervical cancer at Warwick Hospital last year?

A) There were eight cases in 2007, which is again an increase since last year.

Two of the cases were temporary visitors to the area and had never had a smear. Four of the eight cases had no screening history within the last ten years.