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Did you know the pap smear is no more? The two-yearly pap smear test, used from 1991, was replaced by a new five-yearly cervical cancer screening test in 2017. So, if you didn’t know about the change, you might be missing out on a potentially life-saving opportunity.
The original pap test looked for cell changes in the cervix, whereas the new cervical cancer screening test looks for human papillomavirus (HPV) – a viral infection which causes cervical cancer. Both tests require a brief (and sometimes uncomfortable) procedure where a doctor uses a speculum – a metal or plastic tool used to look into the vagina – to take cell samples.
Fortunately, cervical cancer is one of the most preventable cancers. Australia has one of the lowest incidences of the disease in the world due in part to the implementation of the National Cervical Screening Program. In some countries, cervical cancer incidence is above 25 new cases per 100,000 women, compared with a relatedly low incidence of six new cases per 100,000 women in Australia.
Through this article, we’ll explore what you can expect from a cervical cancer test, hear from Sarah Maree who has been diagnosed with cervical cancer and answer some frequently asked questions about the disease and screening process.
The cervical screening test is done in the same way as the pap test. You’ll need to make an appointment with your general practice, family planning clinic, sexual health clinic or women’s health centre to get screened. This might require a longer appointment, so tell the receptionist you are booking a cervical screening test.
During your appointment, you’ll be asked to remove your clothes from the waist down and lie on your back. The doctor will put a sterile sheet under you and give you one to put over you. After putting on surgical gloves, your doctor will insert a speculum into your vagina to widen the upper portion of the canal, allowing the cervix to be seen.
Once the speculum is inserted, your doctor will take a sample of your cervical cells using a small brush. This will be put in a sterile tube and sent to the lab. The whole thing usually only takes a few minutes.
It may take up to two weeks for you to receive test results. If your results are positive, your doctor will tell you the next steps.
The cervical screening takes cells from your cervix and tests them for HPV, which is a common virus that’s spread through sexual activity (and that’s any activity, including intercourse, oral and anal sex).
Up to 80% of people will be infected with at least one type of HPV at some point in their lives. Some types of HPV are completely harmless and go away on their own, while others can cause genital warts and cancer.
Nearly all cervical cancers are caused by HPV; only very rare types of cervical cancer (fewer than 1%) are unrelated to HPV.
If you are 25 to 74 years old, have a cervix and have ever been sexually active, you should have a cervical screening test.
For most women, your first cervical screening test will be two years after your last pap test. This includes people vaccinated for HPV.
If you are turning 25 and have never had a pap test, you should make an appointment to have a cervical screening test.
If you are under 25 and have previously had a pap test – and are not under clinical management for cervical abnormality – you do not need to have a cervical screening test until you are 25.
With a family history of cervical cancer, radio personality Sarah Maree Cameron knew the importance of getting regular check-ups. In 2002, Sarah Maree’s pregnant sister was diagnosed with cervical cancer during a routine pap test. From that moment on, she promised herself to never miss a pap test.
“I was lucky to grow up with a mum who always educated my sisters and I about our bodies and encouraged us to get regular pap tests, now called a cervical screening,” Sarah Maree says.
In 2009, when Sarah Maree started noticing changes in her body, she visited her doctor, was referred to a gynaecologist and after a series of tests, was also diagnosed with cervical cancer.
“Through the support from my family and friends, and particularly that of my mum, sister and all of their friends who had been through a similar journey, I was able to maintain a positive outlook during my treatment.”
Over the course of a year, Sarah Maree underwent several procedures, including having her cervix removed.
“In December 2012, I got a phone call from my gynaecologist saying that as I had successfully gone through my two years with no abnormal results, my remission period had been shortened and I was cleared to return to two-yearly pap tests.”
Now Sarah Maree volunteers with the Australian Cervical Cancer Foundation, helping to raise awareness and encouraging women not to delay their health appointments.
“With regular check-ups, such as a cervical screening every five years for women, you can avoid going through what others have before you.”
Here are a few of the most commonly asked questions about cervical cancer and the screening process:
If cervical cell changes develop into cervical cancer, the most common symptoms include bleeding between periods, bleeding after menopause, bleeding after sex, pain during sex and unusual vaginal discharge.
Many conditions can cause these symptoms, not just cervical cancer. If you have unusual bleeding, discharge or pain, see your doctor.
Changes to the cervical cells do not usually cause any symptoms – this is why regular tests are so important.
The HPV vaccine can help prevent cervical cancer. Vaccines currently available in Australia are called Gardasil and Ceravix. Girls and boys aged 12 and 13 can receive the HPV vaccine for free under the National Immunisation Program at school. People up to age 45 can be vaccinated by their doctor, and there may be a cost involved.
Most people between 12 and 25 years have been vaccinated for HPV. And yes, even if you’re vaccinated against HPV, you need to have regular cervical screening tests if you are over 25 years old. The HPV vaccination does not protect against all types of HPV that can cause cervical cancer.
Yes. Spreading HPV only requires skin-to-skin contact. So, while you may not participate in penile-vaginal or penile-anal penetration, the virus can still be spread through the mouth or genital touching.
Yes. The most common treatment for cervical cancer is surgery and/or a combination of chemotherapy and radiotherapy (chemoradiotherapy).
We can help. Our Find a Provider service allows you to search for health professionals in your local area and see contact information. The practitioners that nib members see more frequently will also display patient reviews.
If you’re heading to your GP for a check-up, it could be a good opportunity to find out what other examinations you might be due for.