Pap Smears (and all the upcoming changes) in a Nut Shell

 

Why do we need to do this damn test?

 

A pap smear aims to detect changes before cervical cancer develops – it essentially prevents cervical cancer as we can intervene (with surgical procedures) before the disease develops. It is important to know that UNTIL the new screening program comes in on December 1 2017 – women should still be undergoing their regular pap smears 2 yearly. So, if you are due now – get it done and don’t let anyone tell you otherwise!

 

What’s the current system for cervical cancer screening?

 

Currently it is recommended that every woman (who has ever been sexually active) in Australia gets a pap smear every 2 years. This includes women who have sex solely with women as the HPV virus is transmitted via skin to skin contact. Currently, we take a sample of cells from the cervix and it is analysed under a microscope to see if there are any changes to the cells to suggest infection with human papilloma virus (HPV) – if it is present we either monitor these women more closely (with 1 yearly pap smears) or send them off to a gynaecologist for closer assessment and potential surgery.

 

What’s the new system and how is it different?

 

On the 1st of December 2017 a new screening program for cervical cancer will be rolled out.

 

The main things you need to know (put very simply and clearly I hope!):

  1. The new screening program will be conducted every 5 years (I heard you sigh from over here ladies!!). Lots of women panic about the increased interval; “won’t you miss things?” is what I get asked. The new test is much more accurate so we know it is safer to leave women for a longer time interval.
  2. Instead of looking for cell changes, the new screening test will look for the presence of the HPV virus that causes the cell changes. See why it’s more accurate? HPV is a virus that many women and men can get infected with – most people never knew they had it. I call it the “cervix cold” to patients – most people get infected, clear the infection and have no problems. The issue however, is that the HPV virus is the cause of cervical cancer in 99.7% of cases. There are many strains but we know that types 16 and 18 are the riskiest when it comes to cervical cancer. This new test will look for the presence of the virus directly.
  3. IF your test comes back showing you have the HPV virus THEN the lab will go onto analyse the cells further to see if there are the changes present (so essentially run the pap smear test we are currently doing).
  4. The new screening program will screen women between 25 and 74. Yes, the age is going up – we used to start screening around 18 years old but we know the rates of cervical cancer in young women are extremely rare. There was a recent study that showed that women under 25 were getting no benefit from the cervical cancer screening program. It is completely safe to wait until 25 to have your first pap smear – unless you have symptoms like unusual bleeding or bleeding after intercourse – in which case everyone should seek a review from their GP earlier.
  5. Your first test should be TWO YEARS after your last pap smear test. ONLY once you have had the new screening test will you go into the 5-year interval program IF your result is normal.
  6. The new screening test will be conducted in the same manner as a pap smear (sorry girls!) – we still need to attain samples but at least it will be every 5 years if you get a normal result, as opposed to every 2 years! There is a plus in there! For high risk populations who get under- screened there is the opportunity to do self- collected samples but for everyone else it’s the same process as before.
  7. Even if you have had the cervical cancer vaccinations – you still need to get the testing done (whether it’s a pap smear or the new test as of December 1 2017). The vaccine covers only 4 strains of the virus – there are many more that can cause cervical cancer.

 

So, there you have it – the pap smear changes in a nut shell for you. Same nut, just cracked a different way if you will.