mythbusting the cervical screening test
Plus, some cool news that will make the test way more comfy for you and your bod.
There’s some pretty rad stuff happening in the world of cervical screening (seriously, your life is about to get a whole lot easier and way less awkward). There’s now a self-collection test that has the same level of accuracy as the GP-administered test – woohoo! This means that if you’re not into the idea of lying down while your GP performs the test on you, you can take the reins and do it yourself really simply.
While shouting this from the rooftops, we thought we’d take this opportunity to also bust some common myths and answer some tricky questions about the Cervical Screening Test. Because, after all, avoiding cervical cancer is super-important. It’s a devastating cancer that can stay silent for a long time; if you have a cervix, it can pop up in your 30s or 40s, and again later in life. Because of where it is in the body (the entrance to the womb from the vagina), cervical cancer can cause issues with organs like your bowel, bladder and uterus. Thankfully, it’s also one of the most preventable cancers because it’s easy to test for.
We sat down with Dr Lara Roeske, a Melbourne-based GP with specific interests in both women’s health and sexual and reproductive health, to ask her a bunch of questions about getting screened for cervical cancer. She’s been doing cervical screenings for more than 20 years, so she most definitely knows her stuff.First things first, who needs to get screened for cervical cancer? Anyone who is over 25, has a cervix and has ever been sexually active. This includes sexual intercourse as well as oral sex, very intimate genital-skin contact (for example as part of safe foreplay) and anal sex. You can stop screening when you hit 74 years of age.
What actually happens when you get screened? We’ve made a really exciting change with cervical screening as of July 1st, 2022. Anyone eligible for cervical screening will be given a choice between either having the doctor or nurse take the Cervical Screening Test sample directly from your cervix (that’s the traditional way that we’ve been doing cervical screening for quite a long time) or you can be supported to collect your own sample from the vagina, which is called self-collection. The self-collection option is just as accurate and just as effective. So, it’s a real choice – it’s not a compromise!
The standard test involves the insertion of a disposable plastic instrument into the vagina so the doctor or nurse can take a sample of cells off the cervix using a swab. You can imagine that process, while it might only take a few minutes, can be uncomfortable. For certain groups of people, it could actually cause fear or distress. The self-collection option involves the doctor or nurse handing you the swab and showing you where to place it (a bit like popping in a tampon). You’d then be given a private place to take the swab at the clinic. It only takes a few seconds to pop the swab into the vagina and rotate it a few times, remove it and pop it back into its tube. It’s then ready to send to the lab for testing. There’s really no pain or discomfort. There’s no need to feel fearful or embarrassed.
Is a pap smear the same as a Cervical Screening Test? The pap smear is the test we did for a long time up until 2017. The Cervical Screening Test is a step up from the pap smear. It can detect the most common types of Human Papillomavirus (HPV) which can cause cervical cancer.
What’s the difference between HPV and cervical cancer? In most cases, cervical cancer is the end result of a persistent infection with a cancer-causing type of HPV. So, the virus (HPV) is the potential cause and cervical cancer is the potential outcome.
Do I need to get screened every year? No, if HPV isn’t found and your screening returns a negative result, you only need to come back every five years.
Is it safe to wait five years between screenings? Yes, it’s absolutely safe. It actually takes almost a decade for an infection with HPV to change the cells. So you should feel comfortable and very safe about the five-year interval. And with the great uptake of the HPV vaccine, we are screening people who already have a fantastic level of protection against being infected with most of the cancer-causing types of HPV because they were vaccinated at school.
What if I get HPV and I’m not due to get screened for three or four years? With any infection of HPV that might occur in the intervening period, we know that most of it will be cleared by your own immune system in 1–2 years, and only very few people will have a persistent infection. Usually that will be picked up at the next round of screening. Also, it takes much longer – almost a decade – for an infection with HPV that hasn’t been cleared to cause serious cell changes, and these changes can usually be treated.
Do people who have had the HPV vaccination still need to get screened? Yes, they absolutely do, and that’s because although the vaccine does protect you against the majority of HPV types that are associated with cancer of the cervix, it doesn’t protect against all.
Do transgender people with a cervix need to be screened? Yes, they do. Unfortunately, we know for a whole lot of reasons, including stigma and misinformation, that we don’t see transgender people as often as we need to for screening (and just generally for their sexual health). So yes, if you’re trans and have a cervix, you definitely should get screened every five years.
Do you need to be screened if you don’t have sex with men? If you’re sexually active (it doesn’t matter who with), you’re over 25 and you have a cervix, then you should come in to be tested. To be super-clear, even if you’re a lesbian or bisexual, you’re still at risk of developing cervical cancer.
Do you need to get screened if you don’t have sex at all? This is a great question because people’s definition of “no sex at all” is very variable. I tend to be really specific and talk to people about what they mean when they say “no sex”. Oral sex, genital skin-to-skin contact, anal sex – these are all forms of sexual activity which put you at risk of sexual transmission of HPV. So again, if you’re over 25, you’ve got a cervix and you take part in any of these activities, but not sexual intercourse, you should have regular screening. If on the other side, you’re 40, never participated in any sexual activities at all and you’ve got a cervix, you don’t need screening because you haven’t been sexually active.
Does the test itself hurt? We’re all very different in our responses to the test. If you’re having the traditional test, the GP will always be looking for any signs of discomfort from you and will do their best to ensure you are comfortable. If at any time you want the doctor or nurse to stop, then please do indicate that. There are a couple of things that can make the test more comfortable, including coming in the week after your period ends, or wriggling your toes or deep breathing during the test. Some people like to have a support person attend as well. And self-collection is of course a fantastic option, as there is no pain, no embarrassment and it’s under your control.
Can you do the test if you have your period? Yes, you can, but we’d suggest not on the heavy bleeding days (usually the first day or two of your period).
Can you still have the test if you’re pregnant? Yes! We know one of the reasons young healthy people come in to see their doctor is when they’re pregnant or think they might be. If you’re over 25 and pregnant, that’s the perfect opportunity to have a Cervical Screening Test if you haven’t had one yet.
Is self-collection as accurate and reliable as a GP-collected test? Absolutely, it’s 100 per cent as accurate and reliable.Making sure you visit your GP for a Cervical Screening Test every five years is one of the best ways to protect yourself from getting cervical cancer. You can check if you’re due for a Cervical Screening Test by calling your GP or contacting the National Cancer Screening Register.
This super-helpful information was brought to you in partnership with the National Cervical Screening Program. If you’re between 25 and 74, have a cervix and have ever been sexually active, make sure you get screened every five years. Find out more on the National Cervical Screening Program website.