Since December 2017, the pap smear/test has been replaced by the cervical screening test.
All people with a cervix who have ever been sexually active are at risk of cervical cancer, regardless of gender identity, sexuality, or the type of sexual activity that you are engaging in. Cervical cancer is caused by the Human Papillomavirus (HPV) and it is one of the most preventable forms of cancer.
Getting routine cervical screening tests (CSTs) is the best way to protect yourself against cervical cancer. Routine CSTs are recommended for anyone with a cervix who has ever been sexually active (with anyone) and is over the age of 25 years. While the HPV vaccine is an important way to protect yourself from cervical cancer, HPV vaccinated people will still be required to get routine CSTs because the vaccine does not protect you against all HPV strains that cause cancer.
In December 2017, a new CST was introduced that:
- Is a lot more effective at detecting the presence of HPV and, as a result, preventing cervical cancer.
- Increases the time between tests from every 2 years to 5 years.
- Requires screening to start from 25 rather than 18 years of age.
- Has an ‘exit test’ for people aged between 70-74 years of age. An ‘exit test’ is a final test to exit the cervical screening program.
If you have been getting pap smears/tests in the past, it is recommended that you get a CST two years after your last pap smear/test and then every 5 years after that, if your results are ‘normal’.
If you are experiencing symptoms such as abnormal bleeding, discharge or pain, visit your local sexual health clinic or doctor.
What does the CST involve?
The CST involves the same procedure as the pap smear/test – a small sample will be taken from your cervix to be tested in the laboratory for HPV infection.
The best time to get a CST is during the middle of our menstrual cycle. This is a few days after your period has ended and a week before your next period starts. It is still possible to get a CST while on your period, but it may not be possible to get a ‘satisfactory’ sample and you may be required to get another CST.
Check out the Where to Test page for sex worker friendly sexual health centres. Many of the clinics listed are also LGBTIQ friendly. Be aware that some sexual health centres may not provide the CST. It is recommended you call in advance before attending the clinic.
If your privacy is breached or you feel you are being discriminated against by a healthcare professional, you may be able to make an official complaint to the service or the health ombudsmen in your state or territory. Refer to the Making Complaints about Health Care Services page or contact your local sex worker organisation for more information and support.
What if my CST results show that I have a HPV infection?
If your CST shows that you have a HPV infection, that does not mean you have cancer. Getting cervical cancer is a rare outcome from having a HPV infection and it can take 10-15 years for a HPV infection to turn into cancer.
If the test detects the presence of HPV, it is possible for your body to clear the HPV infection on its own. However, you will be required to get another CST in 12 months to see if your HPV infection has cleared your body. The laboratory will also perform another test straight away to look for abnormal cell changes.
If the tests show that you have a certain type of HPV, the HPV infection has not cleared in 12 months, or you have abnormal cell changes, then your doctor will refer you to a specialist for further investigation and care.
You may also be required to repeat the CST if you get unsatisfactory test results. This means the laboratory was unable to test the sample taken from the CST and you need to get another test. Unsatisfactory test results can happen if the sample taken was too small or it was taken during your period.
It is important to do any follow-up treatment or testing your healthcare provider asks of you following a CST. Cell abnormalities in the cervix can be treated easily and successfully if they are detected early. But if they are left untreated, it can lead to more serious issues such as developing cervical cancer.
What is Cervical Dysplasia?
Dysplasia means that the way the cells are growing is disorganised and that these abnormal surface cells could be a sign of problems. Dysplasia is most common in people in their 20s. Colposcopy may be recommended if dysplasia is discovered and treatment will depend on the type of cell changes found. A colposcopy is further investigation following an abnormal pap smear or cervical screening, where a colposcope is used to view the cervix. Depending on the severity of the dysplasia, a repeat test may be all that is recommended, or surgery may be required.
What is the National Cancer Screening Register?
The National Cancer Screening Register was also introduced alongside the new CST. The National Cancer Screening Register stores personal details (such as your Medicare details), previous bowel and CST results, and information about your HPV vaccination status. It can also be used to send you reminders to get screenings. Your healthcare provider can request to access your information and submit information into the register. You can also access your information in the register to update or add personal details, check your screening test results, and see when you need to get screened again.