The process for being screened for cervical cancer has changed as of December 1st, 2017. This article is designed to give you an overview of the new process.
What is cervical cancer?
Cervical cancer is cancer of the cervix, the most common type being squamous cell carcinoma (80% of cases).
Adenocarcinoma, a separate type of cervical cancer, is far less common and more difficult to diagnose as it starts higher up in the cervix.
Almost all cases of cervical cancer are caused by persistent infection of the virus known as Human Papilloma Virus (HPV). The HPV virus is a common virus that can cause changes in the cells of the cervix, and rarely, these changes can progress to cancer. The other main risk factor for cervical cancer is smoking.
The risk of a women being diagnosed with cervical cancer by age 85 in Australia is 1 in 168. In 2014, there were 223 deaths from cervical cancer in Australia. Deaths caused by cervical cancer have halved since the introduction of the National Cervical Screening Program in 1991.
Statistics taken from the Cancer Council Australia.
How has the program changed?
Previously, cervical cancer was screened for using the pap smear test. The new test feels the same as the pap smear, but tests for the HPV (human papilloma virus, the virus that causes cervical cancer) rather than testing for changes in the cells that could indicate cancer.
Why has the program changed?
The new program is more accurate, as it tests for the virus that causes cervical cancer (HPV) rather than cell changes in the cervix.
Because the test is looking for the HPV virus rather than cell changes in the cervix, it is safe to wait 5 years in between tests if your results are normal. Even if your test does show that you have HPV, it usually takes 10 years or more for HPV to develop into cervical cancer, and cervical cancer is a rare outcome of HPV infection.
How is the cervical screening test performed?
The test is a simple procedure designed to look at the cervix, which is located at the opening of the uterus (the neck of the womb), at the top of your vagina.
If you have previously had a pap smear, the new test will look and feel the same. The test may feel a little uncomfortable, but shouldn’t cause any pain.
If you have not previously had a cervical screening test, please discuss the process for the test with your doctor, and remember you can request a female clinician if it makes you feel more comfortable.
Who should receive the test?
If you are:
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25 to 74 years old
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Have a cervix
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Have ever been sexually active
You should have your first cervical screening test 2 years after your last pap smear (unless otherwise advised by your doctor). This includes people vaccinated or unvaccinated against HPV, as well as people who identify as lesbian, transgender or otherwise.
If you are turning 25, or have never had a pap test before, please book an appointment with your GP to discuss the cervical screening program.
If your test results are normal, you do not need to be screened again for 5 years under the new program.
Why has the age changed?
Research shows that increasing the age of cervical screening to 25 years old is safe.
The reasoning behind this is:
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Most men and women aged between 18 and 25 have been vaccinated against HPV, and have an efficient immune system, so will clear the virus quickly without treatment
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The incidence of cervical cancer in women under the age of 25 is rare, and after 20 years of screening women aged 18 to 25, the incidence has not reduced
If you are under 25 and have previously been screened with normal results, you will receive a transition letter from the National Cervical Screening Program in the first half of 2018 to advise you of the age that you will need to be screened again. If you have any concerns over the change in this process, or have had abnormal pap smear results in the past, please discuss the process for your screening with your GP.
If you experience any abnormal symptoms, such as pain, abnormal vaginal bleeding or discharge, please book an appointment with your GP to discuss these as soon as possible.
What happens after I’ve been screened?
Depending on your results, there may be further testing of your cervix. Please discuss the results of your screening test with your GP or health professional.
References
Department of Health 2017, About the new test, Australian Government Department of Health: National Cervical Screening Program, retrieved online 27/12/17, < http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/about-the-new-test >
Cancer Council Australia 2017, Cervical cancer, Cancer Council Australia, retrieved online 27/12/17, < http://www.cancer.org.au/about-cancer/types-of-cancer/cervical-cancer.html >
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