Dr Glenda McLaren
Obstetrician & Gynaecologist

Everything You Need to Know About Cervical Screening to Reduce Illness and Death From Cervical Cancer

Having regular cervical screening tests is the best way for women to protect themselves against cervical cancer (the growth of abnormal cells in the lining of the cervix).

According to Australian Government data, about 800 women are diagnosed with cervical cancer in Australia each year, with the average age at diagnosis at 50 years old.

Sadly, about 70% of these cases occur in women who have never screened or were not up to date with their screening. In fact, only about 52% of people who are eligible participate in screening.

The National Cervical Screening Program was established by the Australian Government in 1991, to reduce illness and death from cervical cancer, and create an organised database of health information to ensure women received regular reminders consistently over their lifetime, based on the date of their last screen, and/or their previous results.

Cervical Screening programs have halved the mortality rates from cervical cancer – and the test has changed from ‘Pap Smear’ to the newer ‘Cervical Screening Test’

Screening Works! The Australian National Cervical Screening Program Has Been Very Successful To Date. According To The Cancer Council Australia, Cervical Cancer Incidence And Mortality Rates Have Halved In Australia Since The Introduction Of The Program In 1991.

The screening program initially offered a free Pap test every two years to women between the ages of 18 and 70. Several changes came into effect in 2017, after the introduction of the Gardasil vaccine against specific strains of the human papillomavirus (HPV), which causes more than 95% of cases of cervical cancer. The age eligibility changed from 18 to 25 for a first screening because most women under the age of 25 would by then have been vaccinated for HPV.

Today, women and people with a cervix aged 25 to 74 years of age are encouraged to have a Cervical Screening Test every five years.

What is HPV (Human Papillomavirus)?

And how does it relate to cervical cancer?

HPV is a very common sexually transmitted infection which usually shows no symptoms and goes away by itself. Persistent HPV infection can cause abnormal cells to develop on the cervix. Over a long time, these abnormal cells may develop into cervical cancer if left untreated. HPV is present in nearly all (99.7%) cervical cancer cases. However, not all HPV infections lead to cervical cancer. Source: https://www.cancer.org.au/

Did you know?

The HPV vaccine was first developed by the University of Queensland in Australia by Professors Ian Frazer and Jian Zhou and was approved for use in Australia in 2006.

What are the main differences between a Pap Smear and a Cervical Screening Test

The Cervical Screening Test and the Pap Smear Test are different. The Cervical Screening Test replaced the Pap Smear Test in December 2017. The Pap Smear Test used to look for abnormal cells in the cervix, while the cervical screening test looks for HPV infection.

The new test for HPV can identify women who could be at risk of cervical cancer earlier than the Pap Smear Test could – it is more effective as a test.

Many people might still refer to a Pap Smear, however, the screening test now performed in Australia is the Cervical Screening Test.

Where do you go for a Cervical Screening Test?

Where do you go for a Cervical Screening Test?

  • A GP Doctor’s clinic
  • A community health centre or Women’s Health clinic
  • A private Gynaecologist clinic such as Bloom Women’s Health

Some women may prefer to have their CST performed with their Gynaecologist, who is perfectly placed to address any other women’s health concerns they might have, such as period issues, pelvic pain or menopausal symptoms.

There are now options in how to collect the sample for your Cervical Screening Test

When you are due for your Cervical Screening Test, it can be performed by your GP, a nurse trained in the procedure, or a Gynaecologist. There is also a new option to perform the sample collection yourself called ‘self-collection.’

A self-collection Cervical Screening Test is a new option for patients

Women can now access a self-collection option for their Cervical Screening Test. You still need to go to your GP or specialist, but they can now provide information about the test and instruct you in how to do the test yourself. The self-collection is done while you are at the clinic – it’s just an option that you can do for yourself instead of the doctor or nurse. The sample is then sent by the clinic for testing.

The self-collection option might be preferred as an option for many reasons. It may be a preference for:

  • people who have experienced sexual violence and/or trauma
  • LGBTQI+ people
  • Aboriginal and Torres Strait Islander people
  • people from culturally and linguistically diverse (CALD) communities
  • people living with disability
  • people who have had an uncomfortable experience in the past with procedures or testing
  • people who just prefer to self-collect

Self-collection is an option that allows more women to feel comfortable, and hopefully increases the volume of Australian women who practice regular screening.

What happens during a Cervical Screening Procedure?

Typically, after talking with your doctor, gynaecologist or the nurse, in a private area of the clinic you will be asked to take off your clothes below the waist and lie on your back with your knees apart on the examination bed. You will be given a sheet to cover yourself.

The doctor or nurse will gently insert a speculum (a duck-bill-shaped device) into your vagina, to hold it open. They will then use a swab to take a small sample from your cervix. It may feel strange or uncomfortable but should not be too painful. If it hurts, tell your Doctor straight away. The test only takes a few moments.

How do I know when I am due for my next Cervical Screening Test?

If you are registered on the National Cancer Screening Register, you will receive a mail notification that you are due for a screening every five years, which will contain the latest information about your options for testing. You can also contact the National Cancer Screening Register to update your contact details or ask questions.

If you are not registered, or can’t remember when you are due, contact your GP or Gynaecologist to check if you’re due or overdue for a Cervical Screening Test. If you’re due, you can make a booking.

Can you have a Cervical Screening Test while pregnant?

It is safe for pregnant women to have Cervical Screening Tests. In fact, it can be a convenient time to have a Cervical Screening Test in the early stages of pregnancy, while you are being examined by your Doctor for other matters relating to your pregnancy.

What is included on the Cervical Screening Test results, and what do the results mean?

Cervical Screening Test results usually come back from the lab in about 1-3 weeks. You will never be expected to interpret the results alone – your GP or Gynaecologist will arrange an appointment with you to explain your results and discuss if any further action is required.

The test results will show one of three different results, including:

  1. Unsatisfactory
    An unsatisfactory cervical screening test means that the laboratory staff could not detect enough cells to give a report. In this case, you may be asked to have a repeat test.
  2. Negative
    If your results show that HPV infection was not detected, you will typically be sent a reminder to have your next screening test in five years.
  3. Positive
    If HPV is found, your test result will be Positive. This means that there is evidence of an HPV infection (but not necessarily any cancer cells) – if your test is positive, then it’s important to follow up with your doctor for further diagnosis

What happens if my Cervical Screening Test result is positive?

If your CST results are positive, then additional tests will automatically be done on the same sample of cells in the laboratory. Depending on the results of all the tests, you might have a repeat cervical screening test in 12 months, to see if the HPV infection has cleared. It’s important to remember that HPV infections usually clear on their own over one to two years, and that most abnormal cells are not cervical cancer.

If you are a Bloom Women’s Health patient, your Gynaecologist will discuss your individual follow- up journey with you. Depending on the results, this could mean repeating the test in 12 months or offer of colposcopy assessment next.

What types of follow up procedures might be needed if I need further investigation?

In some cases, you might need to have a follow-up procedure called a ‘colposcopy with biopsy’ or a LLETZ procedure:

  • A colposcopy may be required to identify where abnormal cells are in the cervix, and what they look like. The procedure is usually done by a Gynaecologist – it is available within the Bloom Women’s Health rooms. The Gynaecologist will usually take a small tissue sample (biopsy) from the surface of the cervix for examination under a microscope by a pathologist.
  • Large loop excision of the transformation zone (LLETZ) or cone biopsy might be performed if early-stage cancer cells are detected. It is a procedure performed under a local anaesthetic and removes cervical tissue for examination.

Our Bloom Women’s Health team will support you throughout your care

It is common to feel anxious or worried if you have just found out that your CST is positive. We understand that receiving positive test results can be stressful sometimes. We ensure that we invest in supporting women and empower them with the knowledge so they feel in control of their health issues.

At Bloom Women’s Health, we provide a supportive environment, and our Gynaecologists will help you along you every step of the way through additional tests. We’ll take the time to help you understand your test results, explain any further tests required, and talk through the options to help you understand and make decisions in your care.