Women will be familiar with going along to their GP at least every two years for a Pap smear to screen for cervical cancer. How your GP screens for cervical cancer is changing and it's important for women to understand what the changes are and why they're happening.
What is cervical cancer?
Cervical cancer is a disease that occurs when the cells in the cervix, or the opening to the uterus, start growing out of control. It's the 14th most common cancer diagnosed in women in Australia and nearly 1000 women will be diagnosed with it in 2017. Almost all cervical cancer is caused by a virus called the human papillomavirus (HPV). The types of HPV which cause most cases of cervical cancer are prevented by the Gardasil vaccine. While cervical cancer can be very serious and even lead to death, if it's diagnosed early it will be treatable for most women. For that reason screening for cervical cancer is very important.
So what is a screening test?
A screening test is one done to identify people who are at higher risk of having or ending up with a serious condition such as heart disease or some types of cancer including cervical, breast or bowel cancer. They're done on people who are well and who are usually asymptomatic, meaning they do not have symptoms of the disease. This way a potential problem can be identified and monitored or treated early, rather than waiting until it starts to cause you harm. Screening usually involves asking you some simple questions followed by a test such as a blood test, mammogram or a cervical smear. Your GP will be able to recommend any screening tests which are important for you and how often they need to be done. Screening tests are different to diagnostic tests, which actually diagnose a disease.
What's the current screening test for cervical cancer?
At the moment all women between 18 and 69 are recommended to have a Pap smear at least every two years, though some women need them more often. A Pap smear is where your GP uses a small brush to collect cells from the cervix. These cells are put on a slide and sent to a laboratory. Once there scientists and pathologists look at the cells to identify any changes which may mean a woman is at a high risk of having cervical cancer.
How is all of this changing?
Soon the screening for cervical cancer will change from a Pap smear to the Cervical Screening Test. How the test is done will be very similar, so you won't notice any changes when you have your screening done. Your GP will still use a small brush to collect cells from your cervix. However, once collected these cells will be checked for the presence of HPV. If HPV is detected then the cells will be looked at carefully to identify if there are any changes in keeping with cervical cancer. In this case, you will be closely monitored.
Why is it changing?
This change means that women who are higher risk will be identified much earlier. The screening will pick up when HPV is in their cervical cells rather than waiting until it has caused changes that may lead to cancer. For this reason, the screening doesn't need to be done as early or as frequently. Once the new changes roll out screening will start at the age of 25 and be done at least every five years, though again some women may need to be screened more often. The Royal Australian College of General Practitioners (RACGP) is the body who licences every GP in Australia, and they support the changes as they will identify more women with cervical cancer at an earlier date, as well as being more user-friendly for patients.
Does everyone with HPV get cancer?
Not everyone who is found to have HPV will develop cervical cancer. Up to 80% of Australians have HPV at some time but most people clear it without it causing any harm. By testing for HPV the new screening test will help your GP identify if you're at a higher risk and need closer monitoring, but it doesn't mean you'll definitely develop cancer down the track.
Where can I get more information?
The best place to go for more information about these changes is your GP. They'll be able to explain more about how this will affect you, what you need to do to make sure your screening is up to date and answer any questions you have about the changes. If you have any symptoms that are worrying you or you're concerned about your risk of developing cervical cancer then your GP is the best person to see.