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Cervical Cancer Screening

Recently, significant changes have been made to the National Cervical Cancer Screening Program.  These changes are evidence based and should, in combination with the national cervical cancer vaccination program, result in improved detection of cervical abnormalities and a reduction in the incidence of cervical cancer. 

 

Briefly, the screening program has moved from a 2 yearly cytology based program (where a scientist exams skin scrapings under a microscope), to a 5 yearly viral screening program (utilising the latest advances in viral screening technology to detect Human Papillomavirus (HPV) which is the underlying cause of cervical abnormalities).

Australia has traditionally been a leader in the prevention of cervical cancer, historically having one of the lowest rates of cervical cancer in the world, and the new screening program should continue that admirable tradition.  

Frequently I find that patients are understandably anxious when informed that they have had an 'abnormal' papsmear result.  The information pamphlets provided on this page should hopefully provide the knowledge required to help patients better understand their results.  In brief:

  • HPV is essentially ubiquitous in that, for all intents and purposes, it is almost impossible to avoid exposure to the virus if you are, or have been, engaged in sexual activities.  Indeed, studies indicate that by the time a young adult leaves university they have a greater than 85% chance of viral exposure;

  • Thankfully, for the majority of women infection with the virus is a transient event with the virus generally being susceptible to clearance by the body's own immune system;

  • It is when the virus proves resistant to clearance that it can lead to cellular abnormalities predominantly affecting the cervix.  It is these abnormalities that, if left untreated, have the potential to develop into cervical cancer;

  • Importantly, the typical time-frame from infection, to cellular changes and then to cancer is a process that takes years (up to a decade or more) rather than weeks or months.

There are three questions that I most commonly get asked in relation to abnormal papsmear results:

  • Do I have cancer?

    • Answer - very unlikely, particularly if you have been attending to routine papsmears as recommended by your GP or gynaecologist.​

  • Where did I pick up this viral infection?

    • Answer - the short answer is, "there is no way of knowing".  This is not to dismiss the stress that women understandably feel when informed that they have been infected with HPV, rather, it reflects the latency capabilities of the virus (ie. how long the infection can remain in your body).  This capability measures in years and decades and as such it is not possible to identify when the viral infection was acquired. Equally important to appreciate is that barrier contraception (condoms) is not effective as a preventative measure and that, while male partners are typically the 'reservoir' or source, they themselves have no way of knowing if they are carrying the virus and at this stage there is no treatment for male partners.

  • I had the Gardasil Cervical Cancer Vaccine - how then am I positive for HPV?​

    • Answer - Gardasil (quadravalent), and now Gardasil 9, ​are very effective (approaching 100%) in preventing infection with the HPV subtypes that they cover.  Unfortunately, the vaccine does not cover all of the so called high risk HPV subtypes, of which there are at least 18, nor does it provide protection if you have already been exposed, prior to vaccination, to one of the viral subtypes that it does cover.  It is for these reasons that we continue to recommend routine screening even if you have had the full vaccination programme. 

Being informed that you have an abnormal papsmear result can be a stressful experience.  Assessment in a gynaecological practice allows for thorough investigations to be performed and timely initiation of treatment where required.  Please be assured that we provide a sensitive and understanding environment with care that is based upon the latest evidence and that places your health at the centre of all decision making.

Understanding your papsmear result

Understanding your papsmear result

Introduction to colposcopy

Introduction to colposcopy