In addition to not smoking, there are two important ways of preventing cervical cancer: cervical cancer screening using the Cervical Screening Test and human papillomavirus (HPV) vaccination.
Cervical Cancer Screening
The National Cervical Cancer Screening Program changed on 1 December 2017, when the Pap test was replaced with the Cervical Screening Test.
Cervical Screening Test
The Cervical Screening Test is a simple procedure to check the health of your cervix. The Cervical Screening Test looks for HPV which can lead to cell changes in the cervix.
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 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 Cervical Screening Tests are so important.
Who should have a Cervical Screening Test?,
If you are 25 to 74 years old, have a cervix and have ever been sexually active, you should have a Cervical Screening Test. This includes people vaccinated and unvaccinated for HPV, people who are pregnant, and people who identify as lesbian, gay, bisexual, transgender or intersex. After your first Cervical Screening Test, it is recommended you have another one every five years.
If you have had a hysterectomy or severe changes to your cervix, you should discuss whether you need a Cervical Screening Test with your doctor.
If you have symptoms at any age, such as abnormal vaginal bleeding, pain or discharge, you should discuss these with your healthcare provider immediately.
To learn more about the Cervical Screening Test, talk to your GP or gynaecologist, or see the information on the National Cervical Screening Program website.
Where you can get a Cervical Screening Test?
You can get a Cervical Screening Test at different places Australia-wide, including::
- a doctor’s clinic
- a community health centre
- a women’s health centre
- a family planning clinic
- a sexual health clinic
- an Aboriginal Medical Service or Aboriginal Community Controlled Health Service.
Who can do a Cervical Screening Test
A healthcare provider facilitates the Cervical Screening Test. Providers can include:
- a doctor or general practitioner
- a nurse trained in cervical screening
- a gynaecologist or other specialist
- an Aboriginal and Torres Strait Islander Health Practitioner or Worker (in some states and territories).
If you prefer, you can ask for a female health professional to do your test.
If you are eligible for a Cervical Screening Test, you have the choice to either:
- collect your own sample from your vagina using a simple swab (self-collection)
- have your healthcare provider collect a sample from your cervix using a speculum.
Talk to your doctor, nurse or health worker about which option is best for you.
How is a Cervical Screening Test done?
If you have ever had a Pap test before, the way the Cervical Screening Test is done will look and feel the same.
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 tested for HPV.
What do the results mean?
Your healthcare provider will talk to you about your Cervical Screening Test results. Possible results include:
Return to screen in five years
Your results show you do not have HPV infection. The National Cervical Screening Program will send you a reminder to have your next Cervical Screening Test in five years.
Return to screen in 12 months
Your results show you do not need further investigation but you should have a repeat test in 12 months. This is because you have HPV infection, but do not have one of the highest risk types (HPV types 16 or 18). It is likely to be cleared by your body within the next 12 months.
The repeat test checks if the infection has gone and if so, you can return to five-yearly screening. If the repeat test shows HPV infection is still present, you may need further investigation from a specialist.
If you have HPV infection, it does not mean you have cervical cancer. It takes about 10 to 15 years for cervical cancer to develop, and cervical cancer is a rare outcome.
Refer to a specialist
Your results show you have either:
- a type of HPV infection that requires further investigation
- abnormal cells were found that require treatment
These results do not necessarily mean you have cervical cancer.
Your healthcare provider will refer you to a specialist for a follow-up test called a colposcopy test. This is usually done by a gynaecologist. Your healthcare provider can help you decide who to see for a colposcopy, if you need one.
It is very important you follow the instructions of your healthcare provider if you received this test result.
Unsatisfactory test result
An unsatisfactory test result means the laboratory cannot read your sample. This means you will need to come back for a repeat test in six to twelve weeks.
This result might happen if the number of cells collected is too small. An unsatisfactory result does not mean there is something wrong.
Talk to your healthcare provider if you have any questions about your result.
The HPV vaccine can help prevent cervical cancer. 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 9 and Cervarix.
Gardasil 9 protects against nine types of HPV:
- Two types that are the main causes of cervical cancer in Australia (types 16 and 18)
- The five next most common types that are associated with cervical cancer (types 31, 33, 45, 52 and 58)
- Two types that cause 90% of genital warts (types 6 and 11).
Cervarix protects against two 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.
Females up to age 45 can be vaccinated by their doctor, but 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 Cervical Screening Tests?
Yes – people who have had the HPV vaccine should still have regular Cervical Screening Tests. Regular screening tests are the best protection against cervical cancer.
The HPV vaccine can protect against some HPV infections but doesn’t cover every type of HPV that can potentially cause cancer. The HPV vaccine does not protect people if they have already been infected with the HPV types covered by the vaccine. It also does not treat HPV infections that people already have.
Because of this, it is very important that people continue to have regular Cervical Screening Tests, even if they have been vaccinated against HPV.