Cervical Cancer Screening

We owe many lives to the sacrifice of Mrs Papanicolaou for what is now a commonplace screening test. Dr Georgios Papanikolaou (and Dr Aurel Babeș not long before him) had discovered that by examining the cells of the cervix, they could see if any cancerous or precancerous cells were visible.

We’ve come a very long way since 1923, and from the 1st of December 2017, the pap smear has been replaced with a more sensitive and more specific test known as the Cervical Screening Test (CST).

So what are we testing for?

With the new cervical screening test, a sample from the cervix is tested for the HPV virus itself which is the precursor to most changes. If there is no virus then the test will be conducted in another 5 years. If the test is positive for HPV, the cells in the sample are examined in a laboratory for abnormal changes.

If abnormal cells are present, the abnormality is graded into low or high-grade changes, and your doctor will chat to you about what happens next. These changes are not diagnostic of cancer, but mean we’ll need to do repeat cervical screening sooner, or arrange for further testing to clarify what’s going on.

Who should get a cervical screening test?

Anyone with a cervix who has ever had sex (this includes male to female, and female to female sex) or skin-to-skin genital contact, is recommended to undergo cervical screening.

When should I get a cervical screening test?

Cervical screening starts from the age of 25, though earlier in some circumstances. If the test is negative for HPV your next test will be in 5 years.

If your last test was before the 1st of January 2018, you likely had a pap smear. Your first cervical screening test is 2 years after your last pap smear.

To collect a good sample and reduce the chance of requiring a repeat test, it’s best to wait until your period has finished organising your cervical screening test.

What happens if the result is abnormal?

An abnormal result does not necessarily mean you have cervical cancer. Most HPV infections clear up on their own without any need for treatment. A positive HPV test means the cells are looked at closely under the microscope.

In a small number of women, these changes can progress to high-grade abnormality. And in an even smaller number of women persisting high-grade changes may progress to cervical cancer.

However, 80% of cervical cancers are detected in women who have never had a pap smear or haven’t been having regular screening.

An abnormal result means another test is often required, which may be a repeat cervical test at a shorter interval, or some further tests via a gynaecologist.

What about the HPV vaccine?

The HPV vaccine has been an amazing discovery that Australia can very proudly call a homegrown success story. And while HPV can reduce the risk of contracting some high-risk types of HPV, it doesn’t protect against all causes of cervical cancer, hence why regular screening is still an important step in prevention.