Cervical screening and what you need to know by Dr Kellie Tathem

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An estimated 951 Australian women will be diagnosed and 256 will die from cervical cancer in 2019. Many cases of cervical cancer are preventable with Cervical Screening. In December 2017, the cervical screening test replaced the Pap smear test in Australia. If you are a woman aged 25 to 74, and haven’t had a cervical screening test yet, it’s recommended you do so as soon as you can. The good news is that it is now only needed every five years if your results are normal and you have no abnormal vaginal bleeding. The best news is, this test saves lives.

The cervical screening test is one of the most advanced tests in modern medical science, and because it reduces the rates of cervical cancer, it is free for Australian women.

Read on for more information about the national screening test from Dr Kellie Tathem.

 

What is cervical cancer?

The cervix is a part of the female reproductive system, which also includes the vagina, uterus, ovaries, fallopian tubes and vulva. The cervix is often referred to as the neck of the uterus and sits in the lower part of the uterus that connects to the vagina.

The cervix comprises two kinds of cells: squamous and glandular. Cervical cancer starts at the point where the two cells meet, called the squamocolumnar junction.

Treatments for cervical cancer can include surgery, chemotherapy and radiotherapy.

 

Why is cervical screening important?

The new cervical screening test is a more accurate way of protecting women from cervical cancer. It is thought to protect almost one third more women than the previous Pap test. Cervical cancer can take 10-15 years to develop so if you have ever been sexually active – even just once with either sex – you should still have the cervical screening test.

Where the Pap test looked for pre-cancerous changes in the cells of the cervix, the cervical screening test looks for evidence of the human papillomavirus virus (HPV), which can lead to these cell changes in the cervix. So, in essence the new test looks for the precursor of the precursor of cervical cancer! Research suggests HPV is the cause of cervical cancer more than 99% of the time.

In 2019 it was estimated that 1.4%, or 951, females were diagnosed with cervical cancer and there were 256 deaths as a result of that cancer.

 

 

What is HPV?

HPV is a common virus spread through skin-to-skin contact, often during sex. As I mentioned, most cases of cervical cancer are caused by genital HPV.  Even if you use a condom, you can still be exposed to HPV.  Four out of every five people have at least one kind of HPV virus at some time in their lives, and there are more than 100 strains. There is no treatment for HPV, and the virus does not usually cause any symptoms.

Some HPV viruses are very weak and are cleared by the immune system prior to any effect on the body. Some HPV viruses cause genital warts. The HPV viruses we test for on the Cervical Screening Test are the ones known to be more difficult for even strong immune systems to clear, and therefore are likely to hang around for longer and cause abnormal cells.

 

The HPV Vaccine

Aside from funding the cervical screening test, the Australian Government encourages and funds vaccination all school children aged 12-13 against HPV.  This was introduced as part of the National Immunisation Program (NIP) in 2007. Whilst boys cannot get cervical cancer, it is important to vaccinate them because if they are infected they may unknowingly pass the virus onto their future sexual partners.

Catch-up vaccinations are available for older children aged up to 19, and older adults can pay to have the HPV vaccine.

 

 

When should I start having the cervical screening test?

You should have the test if you’re aged 25-74, have a cervix (have not had a total hysterectomy) and have ever been sexually active. You should ask for an earlier one if you have abnormal vaginal bleeding – especially bleeding with or after intercourse. As with every vaccination, HPV vaccination does not give 100% protection against all HPV, so it is important to still have the cervical screening test.

 

Is it safe to have the test only every five years?

This is a question I get asked very frequently. The short answer is yes. For most women, the time from picking up a virus, to developing abnormal cells and/or cancer is 8-15 years. Compared to the old Pap Test, the HPV test flags that there is a problem much earlier and it is less likely to miss an early abnormality. In European trials with tens of thousands of women, the new screening test and longer screening interval actually provided 70% greater protection than the old Pap Test against Cervical Cancer.

 

What to expect at a screening?

A cervical screening test is collected in exactly the same way as the previous Pap smears were. When lying on your back with your knees bent, a doctor inserts an instrument called a speculum into your vagina so they can see the cervix. They use a brush to then take a sample of cells from the cervix that get sent to a laboratory for an analysis. The test is usually completed within one minute and should cause only mild discomfort. Many women are embarrassed at the thought of having this test done. There is no need to feel embarrassed as this is one of the most common procedures performed by them and they know it is such an important part of protecting your health.

If you would like any more information about cervical screening, please see your GP who can refer you for more information or a further assessment if required. To make an appointment with one of our doctors or gynaecologists at Eve Health please phone 07 3332 1999.

 

Sources and further reading about cervical screening can be found here:

 


Dr Kellie Tathem is an experienced obstetrician and gynaecologist who can offer the complete range of women’s health services at Eve Health. She is also qualified to manage and treat pap smear abnormalities, heavy menstrual bleeding, pelvic pain, painful sex and contraception issues.

Kellie strongly believes in empowering women by providing them with the knowledge to make an informed choice about their healthcare. She strives to achieve this with each patient by staying abreast of the latest developments in her field and discussing these with her patients.

 

 

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