Pap smears are no one’s idea of a good time, but they are a very necessary in preventing deaths from cervical cancer.
From 1 December, however, there are big changes to Australia’s national cervical screening program and the Pap smear as you know it will be gone. Instead, it’s being replaced with a superior test, which means you go in for one less often.
Before you get too excited, the stirrups haven’t gone anywhere. The samples are still collected in the same way and the doctor’s appointment won’t be any less uncomfortable.
To find out what has changed about the new screening program, we spoke to Dr Daria Fielder, a GP at Sapphire Family Medical Practice in NSW.
Introducing the CST
One of the biggest changes of course, is that women aged 25-79 now need to go in for the test only five years instead of every two. Dr Fielder says this is due to changes in how pathologists test the samples, resulting in a test that is far superior to the original Pap smear test.
“We’ve got a new screening program called Cervical Screening Test or CST, it replaces Pap smear,” she says.
“The reason for the change is two factors. One is because the National Immunisation Program includes a vaccine offered to girls and boys at school, which protects them against the human papillomavirus (HPV). As a result of that, we have had a significant reduction of cervical cancer in Australia.”
“The other reason is that we are offering a superior test. So the actual test we are doing is more accurate than the Pap smear test.”
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Dr Fielder explains that sexually-transmitted HPV can cause abnormal cells in the cervix that can develop into cervical cancer. The previous test looked for cells that had been changed by the HPV, whereas the new test tests for presence of HPV itself.
“The actual way it’s conducted is exactly the same, so you still need to go see your doctor and have a gynaecological examination with a speculum,” she says. “The cells are collected the same way, the difference is how they’re processed.”
But if I’m immunised, why have the test?
Those who’ve undergone HPV immunisation might be wondering why they still need to have a screening at all. Dr Fielder says that’s because the vaccine only protects against certain strains of HPV, but not all.
However, because all women under 25 should have had the HPV vaccination and studies show women under 25 saw little benefit to the screenings, the age of your first screening can safely be raised to 25 years old.
Dr Fielder reassured those who were nervous about the lengthening of time between tests, that it’s a decision based on thorough research.
“What we know is that even if you were to contract a high-risk HPV in that time after your screening in those five years, we know that on average it takes between five to ten years for the virus to cause damage to the cells and for cancer to develop.”
When should I have my next test?
This one’s simple. Dr Fielder says that you should still see your GP for a cervical screening test two years after your last Pap smear. She says there’s no need to rush out to have the new test if you’re not due, but that it’s important to know you shouldn’t wait five years after your last Pap smear, because that was the inferior test.
“If you’ve had a test this week and it was negative, you still need to come back, because you’ve had an old test, in two years. Then after you’ve had this new test, you will be asked to come back five years later,” Dr Fielder says.
Another positive change to come out of the federal government’s overhaul of the program is that all women will be signed up to the National Cancer Screening Register, who will send them reminders. Previously, this was handled by each state individually, so if a woman moved interstate she might miss the all-important reminder.
Can’t you do the test yourself now?
Dr Fielder says a self-collection option for the test was supposed to be available from Friday, but will now be possible from a later date. When available, women who are reluctant to be examined by a doctor can use a swab to collect the sample themselves. However, if you can suck it up, it’s better to go for the doctor-collected option.
“It’s been decided that having a self-collected sample is better than not having anything at all,” Dr Fielder says. “It’s the less preferred option because you’re not collecting the cells from exactly the right area.
“It’s certainly not the recommendation, but it’s an option.”
If you have any further questions or concerns, speak to your GP.