In addition to not smoking, there are two important ways of preventing cervical cancer: cervical cancer screening using the Pap test and human papillomavirus (HPV) vaccination.
Cervical Cancer Screening
Note: The National Cervical Cancer Screening Program is changing. From 1 December 2017, the Pap test will be replaced with a new Cervical Screening Test. For more information, see below.
The Pap test, or Pap smear, finds early precancerous changes (abnormalities) in cervical cells. These changes are the first step in a series of slow changes that may develop into cancer if they are left untreated. Detecting these changes with a Pap test means that they can be monitored and – if necessary – treatment can be started to prevent cervical cancer from developing.
Early cell changes rarely cause any symptoms, which is why regular Pap tests are so important.
Who should have a Pap test?
All women who have ever had sex should have a Pap test every 2 years from the age of 18 to 70. This includes:
- women who have been through menopause
- women who have had the HPV vaccine.
If you have had a hysterectomy or severe changes to your cervix, you should discuss whether you need a Pap test with your doctor. You might also have a ‘vault smear’, which is similar to a Pap test but takes cells from the upper vagina instead of the cervix.
When should I have a Pap test?
The best time to have a Pap test is around the middle of your menstrual cycle – from a few days after your period has finished to about a week before the next one is due. This helps ensure that the sample of cells is good enough for testing at the laboratory, and means that you are less likely to have to go back for another test.
However, it is possible to have a Pap test at any time during your menstrual cycle, so if you have irregular periods, don’t let it stop you having a Pap test.
To learn more about Pap tests, talk to your GP or gynaecologist, or see the information on the National Cervical Screening Program website.
Who can give me a Pap test?
You can get a Pap test done by a doctor or women’s health nurse at a:
- general practice
- family planning clinic
- sexual health clinic
- community health clinic
- women’s health centre
- Aboriginal medical service.
How is a Pap test done?
Your doctor or nurse will use a device called a speculum to open the vagina and see your cervix. They will use a small brush or spatula to collect some cells from the cervix. This may feel slightly uncomfortable, but it usually only takes a few minutes.
The cells are sent to a laboratory and examined under a microscope for abnormalities (precancerous cells).
Pap test results are usually available within 2 weeks. Contact the place where you had your test to get your results.
What do the results mean?
Most Pap test results show that the cervical cells are normal.
A small number of test results show changes in cervical cells – these are mostly minor infections that usually clear up naturally or are easily treated. In a very small number of cases, the changes may develop into cervical cancer if the abnormality does not disappear and is left untreated.
If they are found early, changes to the cells of the cervix can be easily managed. Your doctor can explain the test result and discuss treatment, if necessary.
In 2014, the Medical Services Advisory Committee (MSAC) reviewed the evidence from the latest medical research, scientific developments and evidence around cervical cancer. In April 2014, MSAC published its recommendations for changes to the cervical cancer screening program. It recommended that all women, whether or not they have been vaccinated against HPV, should:
- have an HPV test every 5 years
- start cervical screening at 25 years of age
- have a final test to exit the screening program between 70 and 74 years of age
- have a cervical test at any age if they have symptoms such as pain or bleeding.
The Australian Government is preparing to implement the 2014 evidence-based recommendations of the MSAC that a primary HPV test, the Cervical Screening Test, should replace the current Pap test for cervical screening. This change will ensure that Australian women have access to a cervical screening program that is safe, effective, efficient and based on current evidence.
The renewed National Cervical Screening Program will commence on 1 December 2017 when the new Cervical Screening Test will be available on the Medicare Benefits Schedule and the National Cancer Screening Register will be in place to support the renewed clinical pathway.
From 1 December 2017, the Pap test will be replaced with a new Cervical Screening Test.
Until then, if you are aged between 18 and 69 years and have ever been sexually active, you should continue to have your Pap test when due. Delaying your Pap test can put you at greater risk of developing cervical cancer.
For more information talk to your Health Care Professional or read more about the future changes to cervical screening.
The HPV vaccine protects against infection with some types of HPV, which are the major cause of cervical cancer.
The HPV vaccines currently available in Australia are called Gardasil and Cervarix. They are both given as a course of 3 injections.
Gardasil protects against 4 types of HPV: 2 types that cause 80% of cervical cancers in Australia (types 16 and 18), and 2 types that cause 90% of genital warts (types 6 and 11).
Cervarix protects against 2 types of HPV that are the main causes of cervical cancer (types 16 and 18).
Both types of vaccine are very safe and very effective.
Who should be vaccinated?
HPV vaccine is most effective when it’s given to young people before they become sexually active. This is because HPV infection often occurs around the time a person starts having sex, and the vaccine only protects people who have not been exposed to those types of HPV before.
Girls and boys aged 12–13 can receive the HPV vaccine for free under the National Immunisation Program at their school.
People up to age 45 can be vaccinated by their doctor, and there may be a cost involved. However, because the vaccine only protects people who have never been exposed to those types of HPV, the benefit of vaccinating older people may not be as large – older age groups are more likely to have had more sexual partners and therefore are more likely to have already been exposed to several types of HPV.
Do I still need regular Pap tests?
Yes – people who have had the HPV vaccine should still have regular Pap tests. The HPV vaccine can protect against some HPV infections, but regular Pap tests are the best protection against cervical cancer.
HPV vaccine does not protect people if they have already been infected with the HPV types covered by the vaccine. The vaccine also doesn’t cover every type of HPV that can potentially cause cancer.
Because of this, it is very important that women continue to have regular Pap tests, even if they have been vaccinated against HPV.