How is the National Cervical Cancer Screening program changing?
- By Dr Rose Wang
- ● 26 Aug 2016
Australia has one of the lowest rates of cervical cancer in the world, thanks to its effective screening program. Currently, all sexually active women aged between 18 to 70 years of age are recommended to have Pap smears every 2 years.
From May 2017, this will be changing. The new screening program is collected in the same way as a pap smear but tests for the presence of the Human Papilloma Virus (HPV), and is recommended in women aged between 25 to74 years every 5 years.
Why has this change occurred?
This change has been driven by our increased understanding of how cervical cancer develops, newer methods of testing and the advent of the highly successful HPV vaccination program.
We now know that an infection of cervical cells by the HPV virus is implicated in almost 100% of cervical cancer cases. In most cases, this infection is transient and our immune system clears this virus in about 1-2 years, however a persistent infection can lead to abnormal cell changes which may progress to cancer.
This is why from 2017 onwards, the new screening test will detect for the presence of the HPV virus, rather than the current Pap smear which looks for abnormal looking cells. Since a persistent infection by the HPV virus is a pre-requisite to, and occurs before cells start to look abnormal, this new method will detect abnormalities much earlier.
The HPV vaccination program was rolled out across Australian high schools since 2007, which protects against the most common strains of HPV responsible for approximately 70% of cervical cancers. Since its introduction, there has a significant drop in the number of reported high grade abnormalities on Pap smears.
I am younger than 25 years of age. Will I fall through the cracks now that the entry age for screening has been increased?
This is a very valid concern for young women; the good news is that cervical cancer is very very rare in young women, and research has shown that screening in women younger than 25 years of age has not reduced the number of cases nor the mortality from cervical cancer.
Increasing the age of screening also mitigates the risks associated with over-treatment. This is because HPV infection is very common in younger women, though often transient. Over-diagnosis of regressive lesions may actually lead to unnecessary excisional treatment that can lead to increased complications in future pregnancy.
I haven’t been vaccinated against cervical cancer. I’m worried that 5 years is too long an interval for screening.
This is also a very genuine concern, but in fact, because the HPV test is a much better test, the Medical Services Advisory Committee (MSAC) has actually found that a HPV test every five years is even more effective than, and just as safe as a Pap smear every two years.
I have been vaccinated against cervical cancer, do I still need cervical cancer screening?
Yes! Remember that the HPV vaccine protects against only two HPV types that cause about 70% of cervical cancers, so regular screening is just as important for vaccinated women as is for unvaccinated women.
My recent cervical cancer screening results are normal, but I’ve been getting irregular periods, should I be worried?
Remember screening tests are designed to detect early changes in women WITHOUT symptoms, With any test, there always inherent false positive and negatives. If you experience persistent changes that is different to your usual periods, such as bleeding in between periods, bleeding after intercourse, unexplained vaginal discharge or abdominal pain, always see a doctor for further assessment.
Make an enquiry to see any of our doctors to discuss cervical cancer prevention and screening! Clinic 66 provides HPV vaccination, screening and colposcopy.
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