WHAT IS THE CERVICAL SCREENING TEST?
The Cervical Screening Test (CST) aims to prevent cancer of the cervix (also called cervical cancer). Cervical cancer is preventable with regular cervical screening because pre-cancerous changes can be found and easily treated, so cancer does not develop. Most people who do develop cervical cancer have either never had cervical screening or have had screening less often then recommended. Cervical screening saves lives!
WHAT IS THE CERVIX AND WHERE IS IT?
The cervix is the lower part of the uterus (womb) and is located at the top of the vagina.
[ID: A illustration showing the Vagina, Cervix, Uterus and Ovaries]
WHAT DOES THE CERVICAL SCREEENING TEST DO?
The Cervical Screening Test looks for the Human Papilloma Virus (HPV). We now know that HPV causes over 99% of cervical cancer. The Cervical Screening Test has replaced the Pap test. The Cervical Screening Test is a more accurate test and has replaced the Pap test.
WHAT IS HPV?
HPV is a large group of viruses that commonly affect humans. Most HPV types are harmless; however 14 HPV types can cause cell changes that if left untreated, can potentially cause cancer. Two HPV types, 16 and 18 cause the majority of cervical cancer.
HOW DO YOU GET HPV?
You get HPV through sexual activity. HPV is very common, and almost everyone who has ever had sex is exposed to it. You do not need to have had sexual intercourse to become infected with HPV, it also occurs just through close genital skin-to-skin contact. Most people clear HPV themselves without needing any treatment.
WHO SHOULD HAVE A CERVICAL SCREENING TEST?
ALL WOMEN AND PEOPLE WITH A CERVIX AGED BETWEEN 25 AND 74 YEARS AND WHO HAVE EVER BEEN SEXUALLY ACTIVE SHOULD HAVE A REGULAR CERVICAL SCREENING TEST.
If you have only ever had one sexual partner in your life
If you are no longer sexually active
If you are post-menopause
If you identify as lesbian, transgender, intersex, non-binary, or queer
If you are pregnant
If you have had a baby
If you have had the HPV vaccine
(the vaccine does not protect against all HPV types)
WHAT HAPPENS IN MY APPOINTMENT?
The nurse or doctor will talk with you first, ask you some questions about your health, your past cervical screening results and will explain your choices. You may be able to choose how the sample will be collected.
THE CLINICIAN-COLLECTED CERVICAL SCREENING TEST
If you have symptoms or have had a recent abnormal test it is recommended that the nurse or doctor collect the sample. This is called a clinician-collected Cervical Screening Test. To do this they will invite you to take off your clothes from the waist down, including underwear, and ask you to lie down on an examination bed. You can leave your top on, and you should be offered a sheet to cover up if you want it. The nurse or doctor will then gently insert a small instrument called a speculum into the vagina so that they can see the cervix. They will use a soft brush to collect cells from the cervix and place the sample into a container. The test itself should only take about 5 to 10 minutes.
The sample is then sent to the lab to check for HPV. If HPV is detected the lab will do another test on the same sample to look for any cell changes. The information provided by this second test lets your clinician know if you need to see a gynaecologist or just return for a repeat test in 12 months.
WHAT IF I AM WORRIED, FRIGHTENED, OR EMBARRESSED ABOUT HAVING THE TEST?
The Cervical Screening Test is a simple and quick procedure. If you have never had a Pap smear or Cervical Screening Test, ask your doctor or nurse to explain what will happen and to show you the speculum.
If you are anxious or concerned about having the procedure, consider calling us or making an appointment to discuss your concerns first. Remember that the nurses and doctors at Sexual Health & Family Planning ACT are specially trained and highly experienced in cervical screening, do these tests all the time, and work to make the experience a safe and positive one for you. You can also choose to have a self-collected Cervical Screening Test.
THE SELF COLLECTED CERVICAL SCREENING TEST
You may choose to collect your own sample. This is called a self-collected Cervical Screening Test. The self-collected cervical screening test is a test that you do after talking to a nurse or doctor.
• HOW DO I DO A SELF COLLECTED CERVICAL SCREENING TEST?
The test is simple to do. You will be given a red topped tube with a long cotton tip swab in it. You do the test in a bathroom or other private space. You need to wash your hands with soap and water and dry them. Remove your underwear, then twist the red cap and take the swab out of the tube. Locate the red mark halfway down the swab, part the skin folds at the opening of your vagina and insert the swab into your vagina up to test red mark. Gently rotate the swab for 20-30 seconds. Remove the swab from your vagina, put it back into the tube and return it to your nurse or doctor.
• IS THE SELF COLLECTED TEST ACCURATE?
Yes, the self-collected test has been shown to be just as accurate as the test collected by a nurse or doctor using a speculum. The main difference is that when a nurse or doctor collects the sample, they are able to examine your vulva, vagina, and cervix. There are some conditions such as polyps, inflammation, or skin conditions that can only be diagnosed when seen on examination.
• WHAT HAPPENS IF HPV IS DETECTED ON MY SELF COLLECTED TEST?
This is an important question. If HPV is detected it depends on what type it is as to what happens next.
- If type 16 or 18 are detected, you will be referred to a gynecologist for further investigation.
- If one of the other HPV types is detected, you will need to return to your nurse or doctor to have a speculum examination so that a sample of cells can be collected from the cervix. This is important as it will guide what happens next and if you need to see a gynaecologist or just return for a repeat test in 12 months.
• WHAT ABOUT HOME SELF COLLECTED TESTS?
There are several ‘self-testing’ home-based kits being advertised in Australia which are not part of the National Cervical Screening Program. These are not approved and should not be used.
WHAT DO MY TEST RESULTS MEAN?
Cervical Screening Test results include low-risk, intermediate-risk, and higher-risk.
- Low Risk: If no HPV is detected, you are at low risk of developing any abnormality and do not need another test for five years. If you have any symptoms (such as bleeding after sex or between periods) before your next test is due, you should always see a doctor.
- Intermediate Risk: If your test result shows HPV types (not 16 or 18) and the cells are normal or only mildly abnormal, you will need to return for another HPV test in 12 months. If the virus is still present on your second test, you will be asked to test again in another year. It is common to take 1-2 years to HPV.
However, if you have had a self-collected test that shows HPV (types not 16 or 18) you will need to return to see your nurse or doctor so they can collect a sample of cells from the cervix. Self collection is excellent for picking up the presence of HPV but cannot pick up cells that may have changed as a result of HPV. The cell sample collected by your nurse or doctor will guide what happens next.
- Higher Risk: If your test result shows HPV type 16 or 18 (or other HPV types (not 16 or 18) and the cells show significant changes) this means that you are at higher risk of developing an abnormality. You will need to return to see a doctor and be referred to a gynaecologist for further investigation.
WHAT IF I AM UNDER 25?
If you are under 25 and have already had a normal Pap smear in the past, then you do not need to have a Cervical Screening Test until you turn 25.
If you are under 25 and have not yet had any cervical screening, you will be invited to participate in the program when you turn 25.
IS IT SAFE FOR ME TO WAIT UNTIL 25 FOR MY FIRST TEST?
Yes, it is safe because:
- Cervical cancer is very rare in people under 25.
- Most young people will clear the virus themselves.
- Most young people are protected by the HPV vaccine, which reduces the risk of any abnormalities developing.
- Cervical screening did not make a difference in detecting cervical cancers under the age of 25.
- Young people were at risk of unnecessary treatment in the old cervical screening program.
If you did not receive the HPV vaccine and had any sexual activity before 14 years of age, you can ask your doctor or nurse about having a Cervical Screening Test at an earlier age.
WHAT IF I AM 75 OR OLDER?
If you had your last CST between the age of 70-74 and it was normal, you can stop cervical screening. However, you can continue to screen every five years from 75 if you would prefer to.
HOW WILL I KNOW WHEN MY CERVICAL SCREENING TEST IS DUE?
The National Cancer Screening Register keeps all cervical screening results. They will send you a reminder in the mail when your next test is due and a second reminder if you do not attend for screening on time. The clinic where you have your regular Cervical Screening Tests done may also send you a reminder.
WHAT IF I HAVE SYMPTOMS?
Please remember that the routine Cervical Screening Tests are for people without symptoms.
If you have any symptoms such as bleeding after sex, bleeding between your periods, bleeding after menopause, pelvic pain or pain with sex, these need to be investigated so it is important that you see a doctor.
Visit the National Cervical Screening Program website.
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