Australia is at the forefront in the global fight against cervical cancer and we are one of the first countries to offer a Cervical Screening Test (CST) as part of a national screening program. Combined with our human papilloma virus vaccination program, we are on track to be the first country in the world to eliminate cervical cancer. A huge achievement!
But we’re not there yet. There are still large numbers of women who haven’t been screened – either recently or at all – and this puts them at greater risk of developing cervical cancer and potentially dying from this now largely preventable disease. There have been some recent changes to the program so we thought it was worth a refresher course on cervical cancer screening, who should do it, and what the new test involves. If you are a woman or person with a cervix, we urge you to read on to make sure you are up to date with the very latest on this important topic.
What is cancer of the cervix?
The cervix is at the lower end of the uterus (womb) and forms the entrance to it via the vagina. Cancer of the cervix is mostly caused by infection with certain strains of the human papilloma virus (HPV) which is sexually transmitted infection. Over time, the infection can lead to changes in the cells of the cervix which, if left undetected and untreated can go on to become cancerous (malignant).
How common is it?
Since the first screening program was introduced in Australia in 1991, and with the introduction of the HPV vaccination program in 2007, the incidence of cervical cancer has halved, an extraordinary cancer success story. But we still have around 900 Australian women being diagnosed with it each year, most of whom have never been screened or are what we call “under screened” (overdue).
What are the symptoms of cervical cancer?
Symptoms of early cervical cancer can include:
- vaginal bleeding when you do not expect it — for example, between periods, after menopause or after sex
- heavier or longer periods than usual
- unusual vaginal discharge
- pelvic pain
- continual pain during sex
Anyone with a cervix (of any age) who has symptoms should see their GP immediately, even if you’ve only recently been screened.
How does cervical screening prevent cancer?
In 2017, a 5-yearly Cervical Screening Test was introduced, replacing the 2-yearly Pap test in Australia. The Pap test looked for cell changes in the cervix that could lead to cervical cancer, but the Cervical Screening Test looks for HPV – the cause of almost all cervical cancers – before it has the chance to develop into abnormal or cancerous cells.
What is the Cervical Screening Test and who should have it?
The Cervical Screening Test is a simple test to collect a sample from the cervix or vagina. The sample is then tested for signs of the human papillomavirus (HPV). Because the Cervical Screening Test is more effective than the Pap test at detecting and preventing cervical cancers, it is safe to be done every 5 years instead of every 2.
There are two options for having a Cervical Screening Test. One option is to have your GP collect a sample from the cervix. The other option is to collect your own sample from the vagina.
The CST is recommended for all women and people with a cervix aged 25-74 who have ever had sexual contact (of any kind, with any gender), even if they are vaccinated against HPV and even if they are not currently sexually active. There is a Medicare rebate for the CST in this age group, although most GPs recommend screening starts within 5 years of becoming sexually active (this might be before the age of 25 in which case there is no rebate). If you’re aged 75 or over, you can also be screened. The test is safe to have whilst pregnant.
So, what’s new?
If you’re used to having Pap tests every 2 years, you now only need to have the CST every 5 years; your first CST should be done 2 years after your last Pap test or within 5 years of becoming sexually active (any sexual activity with any gender). Collecting your own sample is now an option for most people. Your doctor can let you know if it is an option for you.
What happens if my test comes back positive for HPV?
If your test comes back positive for HPV, you will need to come back and see your GP for a discussion about what needs to happen next. If your doctor collected the sample from your cervix, then the sample can be checked for abnormal cells. If you collected your own sample (from the vagina) you will need to have an examination to check the cells of your cervix.
With the ability for even earlier detection, the Cervical Screening Test is expected to protect up to 30% more women and people with a cervix. Almost all cervical cancers are preventable with early detection, so make an appointment soon to check if you’re due or overdue for a Cervical Screening Test – it could save your life!
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