Most people in Melbourne would be aware that Pap smears are now a thing of the past. The much more effective Cervical Screening Test (CST) has become the gold standard in cervical cancer prevention.
Cervical cancer is caused by abnormal cell growth, the most common form occurring in the cells of the lining covering the cervix.
FACTS ON THIS PAGE
- Self collection tests are now available
- Cervical cancer is on its last legs
- Screening is required less often
- You can begin screening later in life
- A cervical screening test only checks for HPV
- About Dr Achala Manchanda
Your cervix is the doughnut-shaped tissue located at the top of your vagina.
It’s essentially a two-way gatekeeper, channelling menstrual blood from your uterus and guiding sperm into your uterus.
The CST can detect the presence of the most dangerous strain of cancer-causing viruses, the Human Papilloma Virus (HPV), long before cancer forms. The old Pap smear test could only detect abnormal cells or changes in cervical cells – indicating that cancer may be lurking.
HPV can be transmitted through sexual activity involving all types of genital contact, regardless of a sexual partner’s gender. Almost all sexually active adults will come into contact with HPV in their lifetime.
Early detection of the virus allows GPs and gynaecologists to take action to prevent cervical cancer from forming. HPV is found in 99.7% of cervical cancer diagnoses.
Now that you know the basics, here are five CST facts of which you may be unaware.
1. Self Collection Tests Are Now Available
As part of the National Cervical Screening Program, self-collection tests are now available for eligible women. The tests are an excellent alternative for women who have psychological or physical difficulty being tested by a doctor.
Though not as accurate as a GP-collected test (since I can’t see the cervix during the examination), the thought is that it’s better than not being screened.
Speak to your GP if this is an option you’d like to consider.
2. Cervical Cancer is on Its Last legs
The medical world cannot often make such lofty claims, but evidence suggests cervical cancer will be almost wiped out in Australia during our lifetime.
The prevalence of a reliable HPV vaccine, combined with the accuracy of the CST, means that cervical cancer will likely be officially classified as ’eliminated’ by 2028. This classification is when there are fewer than four cases per 100,000 women within the population.
This outstanding result is helped by the HPV vaccine currently being offered to schoolchildren as part of the year seven national immunisation program.
Catch-up vaccines are available through the national immunisation program for people under 20 years of age who missed out. The vaccine works best before people become sexually active, but some opt for it later in life too – talk to your GP if you’d like to know more.
3. Screening is Required Less Often
As necessary as they are, cervical tests aren’t much fun. The good news is that the CST is a five-yearly event instead of every two years for Pap smears.
Thanks to research and medical advancements, a CST is much more accurate. In fact, the tests are so good at detecting HPV that I now recall patients with abnormal results more often.
These call-backs are usually nothing to worry about as HPV often clears up on its own, and I may suggest repeat screening in 12 months.
Like a Pap smear, CST collection involves a speculum examination. It takes around the same time and feels identical.
4. You Can Begin Screening Later in Life
Women’s health doctors used to recommend Pap smears from 18 years. With the CST, we now encourage screening to start from age 25. Even if you’re younger and have already begun Pap smears, you can now hold off until around your 25th birthday – except if abnormal cells have previously been detected. Speak with your GP if this is the case.
Even though CSTs are required every five years, you’ll need to come in two years from your last Pap smear if it happened before December 2017.
You may need annual tests if you’ve had abnormal results in the last few years. Your GP will let you know when you can return to regular five-yearly screening.
Cervical screening can stop after 74 years of age as long as your most recent test is normal.
5. A Cervical Screening Test Only Checks for HPV
As wonderful as it would be for patients and doctors alike, cervical screening won’t test for other gynaecological cancers. These include ovarian, uterine or vulvar cancer.
Unfortunately, screening for these diseases isn’t nearly as effective as cervical screening.
The test also won’t measure a woman’s fertility or pick up the presence of other sexually transmitted infections (STIs). Your GP can always offer to do an STI test at the same time as your CST.
The CST solely focuses on detecting the presence of HPV, making it a fantastic tool to help eliminate cervical cancer from our community.
Dr Achala Manchanda is a local GP at Doctors of South Melbourne.