The Cervical Screening Test (Pap Smear Replacement)
Changes were introduced to the National Cervical Screening Program in December of 2017 as a result of improvements in science, technology and research into how cervical cancer develops.
A primary change was that the cervical screening test replaced the procedure known as the pap smear.
Cervical cancer is one of the most preventable cancers. Routine cervical screening is the best method of protecting oneself against cervical cancer. Avoiding the cervical screening test or being tested less frequently than recommended is a risk factor for developing cervical cancer (Cancer Australia 2017).
What is a Cervical Screening Test?
The cervical screening test is a safe, quick test that can be performed in a few minutes by a doctor, nurse, women’s health centre, community health clinic, or Aboriginal health worker in a clinic or consulting room (NSW Government n.d.).
The cervical screening test is expected to protect almost 30% more people from cervical cancer than the pap smear was able to (Department of Health 2020).
People who have a cervix and are aged 25 to 74 are eligible for the cervical screening test. The cervical screening test is more accurate than the pap smear as it is able to detect the presence of human papillomavirus (HPV), a sexually transmitted infection that is the cause of 99% of cases of cervical cancer (Healthdirect 2018).
It is necessary to undergo the cervical screening test every five years, rather than every two years as was recommended for the pap smear (Department of Health 2020).
It usually takes 10 to 15 years for abnormalities caused by the HPV virus to develop into cancer (Department of Health 2020).
Even if a person has been vaccinated against HPV, they still need to take the cervical screening test. The cervical screening test protects people from certain strains of HPV that cause cancer, but not all (Queensland Health 2018).
What is HPV?
HPV is a very common virus spread through skin-to-skin contact. Generally, HPV does not have symptoms, though it can cause genital warts (Healthdirect 2018).
It is possible to contract HPV the first time you have sex, even if a condom is used. There are over 100 strains of HPV, and four out of five people have at least one kind of strain of the HPV virus (Healthdirect 2018).
Who Should Take the Cervical Screening Test?
- Have a cervix;
- Are 25 to 74 years of age; and
- Have been or are currently sexually active.
The cervical screening test is necessary for people who fit these criteria even if they have been vaccinated against HPV or if they identify as lesbian or transgender (Healthdirect 2018).
What to Expect From the Cervical Screening Test
The test is a simple procedure to check the health of a person’s cervix (the entrance to the uterus from the vagina). It is performed in a private room in which the test will be explained to them by a nurse or doctor.
The procedure requires the removal of the individual’s clothing from the waist down and to lie down on a bed with their knees bent and apart. The doctor or nurse will then gently insert a speculum into their vagina to keep it open and allow them to see the cervix (NSW Government n.d.).
A small brush will be used to take a sample of cells from the cervix. This procedure is often described as uncomfortable, but it should not cause pain (Queensland Health 2018; Department of Health n.d.).
This sample is put into a sterile tube and is sent to a laboratory to be examined. A doctor will then discuss the results with the patient (which should take about two weeks), which may reveal:
- The patient does not have an HPV infection: In this case, they will not need another cervical screening test for another five years and they will be sent a reminder to do so by the National Cervical Screening Program.
- The patient does have an HPV infection: It is likely their body will get rid of the HPV on its own. They will need another cervical screening test in 12 months time. It takes approximately 10 to 15 years for cervical cancer to develop. If the second test is clear, they won’t need another test for five years. If they still have the HPV infection after 12 months, they may be instructed to see a specialist.
- The patient has a certain type of HPV or an abnormality was found: A doctor will refer them to a specialist for further tests, this doesn’t necessarily mean cancer is present.
- The test result was unsatisfactory: Their sample could not be read at the laboratory. It will be necessary to repeat the test in 6 to 12 weeks.
While the procedure is uncomfortable and not something that people generally look forward to, those few moments of discomfort could be life-saving
- National Cervical Screening Program, http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/cervical-screening-1
- Cancer Australia 2017, What are the Risk Factors for Cervical Cancer?, Cancer Australia, viewed 14 January 2020, https://cervical-cancer.canceraustralia.gov.au/risk-factors
- Cancer Institute NSW, How Has Cervical Screening Changed?, Cancer Institute NSW, viewed 14 January 2020, https://www.cancer.nsw.gov.au/cervical-screening-nsw/your-cervical-screening-appointment/what-happens-at-a-cervical-screen
- Department of Health n.d., National Cervical Screening Program, Department of Health, viewed 14 January 2020, http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/the-pap-test-has-changed-more-accurate-less-often
- Department of Health 2020, The Pap Test has Changed: More Accurate. Less Often, Department of Health, viewed 14 January 2020, http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/the-pap-test-has-ch anged-more-accurate-less-often
- Healthdirect 2018, Cervical Screening Test, Healthdirect, viewed 14 January 2020, https://www.healthdirect.gov.au/cervical-screening-test
- Queensland Health 2018, Everything that Happens During Your Cervical Screening Test Appointment, Queensland Health, viewed 14 January 2019, https://www.health.qld.gov.au/news-events/news/everything-that-happens-during-your-cervical-screen
Ausmed Editorial Team
Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile