cervical screening test

Cervical Screening Tests: 5 Facts You Probably Didn’t Know – Dr Sophie Carter

By now most of you would be aware that Pap smears are a thing of the past. Since December 2017, the MUCH more effective Cervical Screening Test (CST) has instead become the gold standard in cervical cancer prevention.

Cervical cancer is caused by abnormal cell growth, the most common form occurring to the cells of the lining covering the cervix. 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, Human Papilloma Virus (HPV), long before cancer forms. The old Pap smear test could only detect abnormal cells or changes in cervical cells – an indication 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 gynaecologist to take action to prevent cervical cancer 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. Cervical Cancer Is on Its Last Legs

It’s not often that the medical world can make such lofty claims, but evidence suggests cervical cancer will be 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.1

This wonderful result is helped along by the HPV vaccine currently being offered to school children as part of the year seven national school immunisation program. There have also been some catch-up programs for young women since 2007.

2. 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 as opposed to 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. 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.

3. You Can Begin Screening Later in Life

Doctors used to recommend Pap smears from 18 years. With the CST, we encouraged screening to start from age 25. Even if you’re younger than this and had already started 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 test 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 was normal.

4. Self-Collection Tests Are Available

The National Cervical Screening Program facilitates ‘at home’ HPV screening for eligible women. These self-collection tests are an excellent alternative for women who have psychological or physical difficulty being tested by a doctor.

You have to be at least 30 years old, not have had a Pap smear in the past four years or more, and refuse to have an in-clinic CST.

Though not as accurate as a GP-collected test (since we can’t see the cervix during the examination) the thought is that it’s better than not being screened at all.

Speak to your GP if this is an option you’d like to consider.

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, the screening programs for these diseases aren’t nearly as effective as a CST.

The test also won’t measure a woman’s fertility or pick up the presence of other sexually transmitted infections (STI). Your GP can always offer to do an STI test at the same time as your CST.

The CST solely focusses on detecting the presence of HPV, making it an amazing tool in eventually eliminating cervical cancer from our community.

Dr Sophie Carter is a GP at Doctors of South Melbourne. She has special interests in women’s health, sexual health and complex health needs.

1 https://www1.racgp.org.au/newsgp/clinical/australia-on-the-verge-of-eliminating-cervical-can