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But first cancer of the cervix. Could testing for infection with the human papilloma virus take over from smears as the main screening tool for the disease?

A committee advising the Food and Drug Administration in American has just unanimously approved the adoption of the new technology and it is likely that the UK will follow suit.

The test works on the principle that HPV — which at least half of all sexually active women will pick up at some stage - accounts for nearly all cases of cancer of the cervix.

And that testing for it is a more accurate way of picking up those women most at risk from the disease. The conventional way of looking for abnormalities that might lead to cervix cancers, the so-called Papanicolaou smear or the cytology test, this basically takes a small scrap of cells from the cervix and looks at them under a microscope and looks for abnormalities in the cells.

I guess almost two decades now it was discovered that in fact virtually all cervix cancer is caused by a virus — the human papilloma virus.

And there are about 14 types of that virus that can actually cause cervix cancer. The test is much more sort of high tech in a way.

Cytology is basically staining a conventional glass slide and a specialist actually looking at that slide for abnormalities.

The Americans look set to adopt HPV testing as the first step in screening for cancer of the cervix.

HPV testing is now used as a secondary test for women that have cytology abnormalities that are slightly abnormal but not that serious to decide how to manage them.

Routinely we do cytology now every three years up to age 50 and then every five years. So we can extend the interval and probably after two negative HPV tests it can be extended even beyond five years.

What happens then? Certainly women will routinely be coming in contact with HPV and will be getting exposed all the time but in fact the time from exposure to cancer is probably of the order of years and the time from exposure to even early changes is a few years.

We know that many, many human papilloma virus or HPV infections are transient. Most HPV infections will actually be cleared spontaneously by the body with no change.

Routine vaccination against HPV was introduced into the UK six years ago, so will vaccinated women need to be tested? So screening will need to take place but probably less often, maybe once every 10 years.

Professor Jack Cuzick. Margaret, we should start by clarifying that women are not going to notice much difference between this new test and a conventional smear.

Yes, so the cells that are taken from the neck of the womb, from the cervix, are tested for HPV virus. And this is one of the criticisms of the existing smear programme, that it unnecessarily worries an awful lot of women.

But I suppose the bottom line is would the introduction of this test improve the accuracy of our cervical cancer screening programme?

Yeah, so what the offer then would be and what the FDA in America have said that instead of doing a cellular examination first, a smear test first, you would test for HPV first.

Oral cancer is an umbrella term for cancers of the lips, mouth, tongue, tonsils, and back of the throat or pharynx. A rise that has been accompanied by a significant increase in the number of those cancers infected with HPV.

Andrew Shackie is a head and neck cancer surgeon and clinical lecturer at the University of Liverpool. Which strains of HPV virus are we talking about — are they the same ones that are causing the problems in cancer of the cervix?

There have been a variety of theories put forward and one would be a change in sexual practice, perhaps 20, 30, 40 years ago that has allowed an increase exposure to virus to the oral cavity and to the oropharynx and a consequent increase in potential for malignancy to develop.

We know that number of sexual partners and number of oral sexual partners strongly associated with an increased risk of HPV positive head and neck malignancy.

So this is typically males in their mids and we would assume that their exposure to high risk HPV occurs around the time of sexual debut.

So this is potentially a long slow process from infection to the development of the cancer. Of course with cancer of the cervix we can use that to screen for abnormalities.

Is there any similar thing that we can do in the mouth and throat? Is there any evidence that it would offer similar protection against head and neck cancers that are caused by HPV?

But it would be sensible to suggest that if we vaccinate individuals with a systemic vaccine that it would have a flow on effect across all sites that are affected by HPV positive malignancy.

Andrew Shackie. And you will some useful links to more information about the causes, symptoms and treatment of oral cancers on the Inside Health page of the Radio 4 website.

And he is not alone in thinking that a late meal is more likely to end up on your hips or indeed your waistline. But is there any science behind the approach?

If we do controlled studies in the laboratory where we balance the number of calories in the different ways of eating it really makes absolutely no difference whatsoever.

Because tradition would have it or traditional belief would have it that if you eat too late, as is advocated by this diet, that the food hangs around and somehow goes straight to your hips or your tummy or your chin.

Well of course what happens in our controlled metabolic studies is not the same as what happens at home. Lots of these studies have done very short measurements, so they give you a meal and then they just measure it for the next couple of hours.

But if you do longer term studies over 24 hours what you realise is it all evens out in the end. And so I think we are often misled by very short term studies.

If you absolutely control everything people are consuming and you measure over a whole day…. Not on their weight.

But if you eat small and often there may be some metabolic advantages, you might perhaps lower your risk of cardiovascular disease or diabetes because you get a more stable metabolic profile, if you like, across the day.

And that may be a very good strategy for reducing metabolic risk if you can keep a lid on your total calorie intake.

So how are these diets working — the diets that say you can eat what you like between nine and five?

And so it's one of a number of rules people might adopt to help them control their calorie intake. But the truth is they did a whole mass of things differently — they had a much smaller variety of foods, they had less convenience and process foods and of course they did rather more exercise than most of us do today.

We may not be quite so keen to adopt the whole of the s diet. And if there is an issue that is confusing you, please do get in touch.

You can e-mail insidehealth bbc. Regarding the issue of sugar one of your male contributors said there was no such thing as a sugar craving.

Perhaps he should consider the female PMT cycle and the associated sugar cravings brought on by hormonal changes.

To be fair to the experts that we interviewed Jane I think they were suggesting that cravings are not necessarily indicative of an addiction.

I was disappointed by the piece on thrush. My first outbreak occurred when I was 19, tests always show candida present.

I no longer have baths, or soap, have tried every home remedy going as well as using products designed to reduce thrush growth.

Obviously in cases where the diagnosis is confirmed that requires a different approach to management but that was beyond the scope of the item, which is why I directed listeners to our website where there was information on diagnosing and managing recurrent cases like yours.

So I hope that that helps. Mark Wescott — a Consultant Eye Surgeon from Moorfields — got in touch to comment on our recent item on advances in cataract surgery where we looked at multi-focal lenses that correct both near and distance vision negating the need for specs.

Standard fixed lenses — the type offered to most NHS patients - can give excellent results, he writes, and multifocal lenses are not suitable for everyone.

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And this is one of the criticisms of the existing smear programme, that it unnecessarily worries an awful lot of women. But I suppose the bottom line is would the introduction of this test improve the accuracy of our cervical cancer screening programme?

Yeah, so what the offer then would be and what the FDA in America have said that instead of doing a cellular examination first, a smear test first, you would test for HPV first.

Oral cancer is an umbrella term for cancers of the lips, mouth, tongue, tonsils, and back of the throat or pharynx. A rise that has been accompanied by a significant increase in the number of those cancers infected with HPV.

Andrew Shackie is a head and neck cancer surgeon and clinical lecturer at the University of Liverpool.

Which strains of HPV virus are we talking about — are they the same ones that are causing the problems in cancer of the cervix? There have been a variety of theories put forward and one would be a change in sexual practice, perhaps 20, 30, 40 years ago that has allowed an increase exposure to virus to the oral cavity and to the oropharynx and a consequent increase in potential for malignancy to develop.

We know that number of sexual partners and number of oral sexual partners strongly associated with an increased risk of HPV positive head and neck malignancy.

So this is typically males in their mids and we would assume that their exposure to high risk HPV occurs around the time of sexual debut.

So this is potentially a long slow process from infection to the development of the cancer. Of course with cancer of the cervix we can use that to screen for abnormalities.

Is there any similar thing that we can do in the mouth and throat? Is there any evidence that it would offer similar protection against head and neck cancers that are caused by HPV?

But it would be sensible to suggest that if we vaccinate individuals with a systemic vaccine that it would have a flow on effect across all sites that are affected by HPV positive malignancy.

Andrew Shackie. And you will some useful links to more information about the causes, symptoms and treatment of oral cancers on the Inside Health page of the Radio 4 website.

And he is not alone in thinking that a late meal is more likely to end up on your hips or indeed your waistline. But is there any science behind the approach?

If we do controlled studies in the laboratory where we balance the number of calories in the different ways of eating it really makes absolutely no difference whatsoever.

Because tradition would have it or traditional belief would have it that if you eat too late, as is advocated by this diet, that the food hangs around and somehow goes straight to your hips or your tummy or your chin.

Well of course what happens in our controlled metabolic studies is not the same as what happens at home.

Lots of these studies have done very short measurements, so they give you a meal and then they just measure it for the next couple of hours.

But if you do longer term studies over 24 hours what you realise is it all evens out in the end. And so I think we are often misled by very short term studies.

If you absolutely control everything people are consuming and you measure over a whole day…. Not on their weight. But if you eat small and often there may be some metabolic advantages, you might perhaps lower your risk of cardiovascular disease or diabetes because you get a more stable metabolic profile, if you like, across the day.

And that may be a very good strategy for reducing metabolic risk if you can keep a lid on your total calorie intake. So how are these diets working — the diets that say you can eat what you like between nine and five?

And so it's one of a number of rules people might adopt to help them control their calorie intake. But the truth is they did a whole mass of things differently — they had a much smaller variety of foods, they had less convenience and process foods and of course they did rather more exercise than most of us do today.

We may not be quite so keen to adopt the whole of the s diet. And if there is an issue that is confusing you, please do get in touch.

You can e-mail insidehealth bbc. Regarding the issue of sugar one of your male contributors said there was no such thing as a sugar craving.

Perhaps he should consider the female PMT cycle and the associated sugar cravings brought on by hormonal changes.

To be fair to the experts that we interviewed Jane I think they were suggesting that cravings are not necessarily indicative of an addiction. I was disappointed by the piece on thrush.

My first outbreak occurred when I was 19, tests always show candida present. I no longer have baths, or soap, have tried every home remedy going as well as using products designed to reduce thrush growth.

Obviously in cases where the diagnosis is confirmed that requires a different approach to management but that was beyond the scope of the item, which is why I directed listeners to our website where there was information on diagnosing and managing recurrent cases like yours.

So I hope that that helps. Mark Wescott — a Consultant Eye Surgeon from Moorfields — got in touch to comment on our recent item on advances in cataract surgery where we looked at multi-focal lenses that correct both near and distance vision negating the need for specs.

Standard fixed lenses — the type offered to most NHS patients - can give excellent results, he writes, and multifocal lenses are not suitable for everyone.

And talking of advances in surgery, how about having your gallbladder removed by a technique that leaves no scar? All that results in faster healing, a faster return to normal activities and perhaps also even less complications.

There is absolutely and this is sort of where it leads to where we are today because laparoscopic or keyhole surgery has been around for 20 years and a few years ago we had this idea of not having any incisions at all in the abdominal wall and going through natural orifices.

A very confident Mikael Sodergren, who assures me that clever robots — like their prototype iSnake — could one day do emergency surgery outside hospitals, without anaesthetic.

And not a mark left on them. All very science fiction. Join me then to find out more. Series that demystifies health issues, bringing clarity to conflicting advice.

Main content. Listen now. Show more. Show less. Available now 28 minutes. Last on. Tue 18 Mar More episodes Previous.

Sugar, Prescription charges, Thrush, Iron and strokes. Programme Transcript - Inside Health. Downloaded from www.

Cuzick The conventional way of looking for abnormalities that might lead to cervix cancers, the so-called Papanicolaou smear or the cytology test, this basically takes a small scrap of cells from the cervix and looks at them under a microscope and looks for abnormalities in the cells.

Porter The Americans look set to adopt HPV testing as the first step in screening for cancer of the cervix.

Cuzick Certainly women will routinely be coming in contact with HPV and will be getting exposed all the time but in fact the time from exposure to cancer is probably of the order of years and the time from exposure to even early changes is a few years.

Porter So what happens to women who test positive? I'm sorry, I Thief who made 'chicken noises' arrested. Officer McFly commended "Removing that grime sure is a lot of work.

Wait, is that the Lincoln assassination? Prosecution burns that The Vatican's plan for 'curing homosexuals' apparently involves sending them to a restrictive place Subby is not sure if these rooms are epic expressions of assertive manhood, or if he should crawl under the Federal Judge: Sex parties are not protected under the 1st Amendment Hipsters are liked one place in the world, in Dublin OK just a little bit but still Miss my cousin yet?

They don't make people who know from "Gules a fess between in chief a mullet of six points argent Pull a gun on another motorist? That's an arr-I"m sorry what?

Oh, right. No problems here Airbus's hellish designs are the stuff of future commercial airlines. Enjoy your present day cattle car News: Miss France stripped of her title for posing topless.

Fark: photo is SFW. Come on France, you used to Bear Armed Fark NotNewsletter: A day late and there never were any dollars Nobel Prize in physics awarded to pair who proved neutrinos are Catholic Photoshop this apple transfer Halloween burger causes terror in bathrooms Trade agreement to lower drug cost, drop import tariffs, create universal working conditions, break China's But if he didn't have the Guy whose mug shot suggests he's been accused of being gay all his life is charged with cold-cocking a World Domination Next.

Expecto Patronum! Yaron Schoen on Twitter: "The publishing industry in one screenshot. Tim Cook on Twitter: "Remembering Steve for who he was and what he stood for.

We honor him by Interpret iOS logs. Typography Works. Do you want to In between the Not Fast. Coli Strain Produces Ashley Judd says she was sexually harassed by a October 6, Islamic State executes 70 members of anti-IS Future of Calif.

Drug Abuse. Oh, Golly! AidRefugees: Heeding the Presidents Call to Clarifying a Point on Gun Politics. If only winners get paid, then why did Carly Men Need to Lean Out.

Android 6. Which Is America's Best City? Aaron Sorkin and Danny Boyle reveal how they Fortress fund wildly bearish on emerging markets. LinkedIn Groups gets a redesign and a Buddy Michini on commercial drones.

Hands-on: The Surface Book has turned me into a Google's infamous brain-teaser interview Neutrino flavor changes take home the physics Paris police are keeping a fiercer eye out for Get Ready for Windows 7 'Release Candidate'.

In depth: 5 things Twitter needs to improve if Team Clinton giving up on New Hampshire? Christian Prophet Clearly Walks on Air.

Undiscovered Hawaii: Lanai, Kahoolawe, and Niihau. Trend Bomber. From 0 to 5, Planets in Exactly 20 Years.

Hand Cut Dovetails for Dummies. Mike Petrillis Sudden Confirmation Concern! The Most Embarrassing Moments in the History of EU ruling means Facebook and Google cant send Calling all palaeo bloggers!

Tiny ancient fossil from Spain shows birds flew Cacti are endangered for a surprising reason. The New Worldchanging Is Coming.

Sustainable Forestry is Keeping the Nations To save chocolate, big food companies have Lexus has created a drivable electric car made Tiny orphaned possum snuggles back to life.

The Lumia vs. Garb: Vertical. The Witcher 3: Hearts of Stone launch trailer Top Ten Innovation Report for October. Former US national security officials back The Pastis Fairytale Islands.

Adam Harrison Levy: Vulgar Lives. Eddie Hamilton Interview. Links for [del.

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