Since the introduction of the National Cervical Screening Program in 1991, incidence and mortality of cervical cancer has halved. The number of cases, however, still remains unchanged, with 10 new diagnoses each year and 2 deaths in every 100,000 women.
In 2015, Australia saw 3.8 million women participate in cervical screening, this represented 55% of the total population of 20–69 year olds. Sadly, participation is on a downward trend.
2017 saw a new cervical screening program released in Australia to help improve the efficiency of testing. Academics hope that with the improved vaccination program and cervical screening, over 13 million cases of cervical cancer could be prevented in the next 50 years.
If these strategies are implemented worldwide, researchers have estimated that by the end of the century, the level of cervical cancer could be so low that it could be considered as eliminated. So it’s time we all got on board.
The cervix in the female anatomy is the gateway to the womb. It is located at the top of the vagina. By having a cervical screening test it helps to detect any abnormal cells that may go on to causing cervical cancer.
Traditionally, the Papanicolaou test (PAP test) was used for this purpose, it involved collecting, staining and microscopic examination of the cells from the cervix. If abnormal cells were found they were removed to stop cervical cancer developing. The PAP test relied on cell changes being visible under a microscope and so it was recommended to have this every 2 years and was offered to those aged 18–69 years of age.
It was later discovered that Human Papilloma Virus (HPV) causes cervical cancer and the first HPV test was invented 15 years later. It is this principle that we use today which forms the basis of the cervical screening test. Cells are taken from the cervix in the same way as the traditional PAP smear but instead of looking for cell changes it looks for the types of HPV which can cause cells to change and in some cases cause cervical cancer. HPV is the cause of more than 99% of cervical cancers.
HPV is very common, in fact it’s so common that many of us including men, will have it at some point in our lives and not know about it as it has no symptoms. There are a lot of different types of HPV infections — to be precise — there are over 100 of which at least 14 are considered high risk and can cause cancer.
HPV is spread from genital skin to skin contact and it is considered the most common sexually transmitted infection. Most HPV infections will be naturally cleared up by your own immune system within one or two years without causing problems. In rare cases your body may not clear it and so your doctor may refer you onwards for further management.
If your test does not indicate a HPV infection, it is safe to wait five years between tests. Even if your test shows you have HPV it usually takes 10 or more years for HPV to develop into cervical cancer and cervical cancer is a rare outcome of a HPV infection. Your doctor will guide you if you have any abnormal results.
In Australia, the new cervical screening test is available from the ages of 25 to 74 years old every 5 years and is open to hetero and homosexual women, transgender and intersex, as anyone who engages in genital skin to skin contact with a person of any gender can be infected with HPV.
The age has changed due to several factors, firstly, cervical cancer in this age group is rare and in 20 years of screening, the incidence of cervical cancer or death has not reduced in this age group. Furthermore, Most people between 12 and 25 years have been vaccinated for HPV.
Those who are under 25 and have had a previously normal test will be notified when to return for a repeat screen. For those who have had abnormal results in the past should still have follow up tests as recommended by the treating physician. Regardless of age, it is important that anyone who has symptoms such as unusual vaginal bleeding discharge or pain during sex must see their healthcare provider as soon as possible.
The test itself is very quick and should not be painful however it may be uncomfortable. Your practitioner will offer you a chaperone if wished and you will be asked to remove your garments from the waist downwards and place your legs apart on the couch. A plastic speculum is then inserted into the vagina and a quick sample is taken.
Cervical screening is offered from the ages of 25 to 74 years old in Australia. If you are outside of these age groups and are suffering from symptoms such as abnormal bleeding — for example in between periods, after intercourse or even after menopause it is important to seek the advice from your medical practitioner for further tests.
So if you or a loved one hasn’t had their screen in a while it’s time to book in and fight cervical cancer together.