What is the new test?
Until December, 2017, the pap smear has been used in Australia to screen for cervical cancer. The pap smear is performed by collecting cells at the junction of the endocervix (inside of the cervix) and ectocervix (outside of the cervix) with a brush. These cells are then placed on a slide or in a liquid and looked at under a microscope to see if there are any abnormal cells that may indicate pre-cancerous or cancerous changes. With the new test, instead of looking directly for abnormal cells, the cervical screening test will look for the virus, human papillomavirus (HPV). Women will still need the same procedure involving a vaginal examination but instead of the lab looking for abnormal cells, they will first be trying to detect the presence of HPV.
What is HPV?
HPV is the virus that pre-disposes to cervical cancer and is responsible for more than 99% of cervical cancer. HPV is very easily transmitted via skin contact during sexual activity and is extremely common in both men and women who have ever been sexually active. In fact, most people who have ever been sexually active will have been infected with a strain of HPV at some point, often without even knowing it. Like most viruses, the body’s immune system will try to fight it naturally and generally is successful at removing it. But sometimes, the virus is able to cause the cells of the cervix to become abnormal and rarely, results in cervical cancer. So by looking for HPV on the new test, we are looking one step before the abnormal cells develop.
What does a positive test mean?
A positive result on the new cervical screening test means that HPV has been found in your sample. All abnormal results should be discussed with your doctor to decide on the management plan most appropriate for you. You may need increased surveillance or you may require a referral to a specialist to have further testing.
What age should women start having the cervical screening test?
Traditionally women have started having pap smears between the age of 18 to 20. With the new cervical screening program, women will not need to start having the HPV test until 25. This is great news for many women. One exception to this is if you became sexually active at an age under 14. For these women, a once off cervical screening test between the age of 20 and 24 is funded by the Government.
I had the HPV vaccination, do I still need screening?
A vaccination against HPV has been on the National Immunisation Program since 2007. Currently males and females receive this vaccination for free in Queensland as part of a school based program in year 7. It requires three doses over a six month period for complete effect. This vaccination directly targets the strains of HPV most responsible for causing cervical cancer. However, it does not protect against ALL strains. So whilst the vaccination is good news for reducing cervical cancer, it is still recommended that women undergo regular cervical screening even if they have received the full course of the vaccination.
How often should women have the cervical screening test?
The music to most women’s ears is the reduced frequency of cervical screening. Instead of the two yearly pap smear, the HPV cervical screening test will only need to be performed every five years. This applies to women who have always had negative results in the past and have no symptoms. Any woman who has had previous abnormal pap smears or is experiencing symptoms such as discharge or a change in bleeding (eg after sex or in between periods) should see their GP or gynaecologist to work out what testing is best for them.
Does this mean I can wait five years since my last pap smear?
Unfortunately, no. Because your last screening would have used the pap test you still need to return at the two year mark to have your next cervical screening test. Once you have had this test and providing it is all normal you can then wait the five years.
When can I stop having cervical screening?
Women will be eligible to exit the cervical cancer screening program once they have a negative result between the age of 70 and 74.
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