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I'm over 25

Why should I do the test?

The test itself takes around two minutes and is a simple procedure that could save your life.

Cervical cancer is the growth of abnormal cells in the lining of the cervix. Left undetected, cervical cancer can be life threatening, and may need to be treated with surgery, radiation therapy or chemotherapy.

A positive HPV test can show that you could be at risk of cervical cancer before the cancerous cells even begin to grow. You can then have treatment that will prevent cancer from developing in the first place – and this treatment will be much less invasive than it could have been otherwise.

This year about 250 women in Australia will die as a result of cervical cancer – and this number would be much higher if cervical cancer screening wasn’t offered to Australian women. We can continue to reduce the number of cervical cancer deaths by encouraging more women to get screened. We encourage all women to talk to their mum, sisters, aunts and friends about cervical screening.

Put simply, the cervical cancer screening program saves lives. As cervical cancer survivor Kirsten McCreghan says, getting screened could be the best decision you ever made. 

It’s just a few moments of discomfort for something that could save your life.

– Kirsten McCreghan, cervical cancer survivor

You can read Kirsten’s story or find out more information on cervical cancer on our website.


When do I start testing?

Women should start cervical screening at age 25. Women who turn 25 after 1 December 2017 will receive an invitation around their 25th birthday for their first HPV test.  

Women who had a normal Pap smear test in the two years before 1 December 2017 will receive an invitation to attend their first Cervical Screening Test two years after their last Pap smear.  

If it’s been more than two years since your last Pap smear test, you should talk to your doctor as soon as possible about being screened.


What can I expect at my first Cervical Screening Test?


For some women, the first cervical cancer screening can be a bit worrying, particularly if they’re not sure what to expect. The good news is that the whole procedure is usually done within just a few minutes.

On the day

When the time has come for your first Cervical Screening Test, try to stay as relaxed as possible. This will help ensure any physical discomfort is kept to a minimum.

The doctor or nurse will ask you to remove your clothing from the waist down, and to lie on your back or side. You might be given a sheet to lie across your stomach and thighs so you’ll be a little more covered.

Once you are comfortable. you will be asked to bend your knees so the heels of your feet are near your bottom. After opening your knees, the doctor or nurse can begin the procedure by inserting an instrument called a speculum into your vagina. The speculum holds the walls of the vagina apart and allows a clear view of the cervix. It is usually plastic and disposable, but some cervical screening providers prefer to use a metal one.

For some women, this part of the test can be a little awkward to start with, and you might find it a bit embarrassing. Just remember that this is a common test that most women have, and for the doctor or nurse it's a very normal part of their job.

Once the speculum is in place, a brush is inserted through it to take a sample of cells from the cervix. This may feel a bit strange or uncomfortable but shouldn't be painful, and it takes less than a minute or two. Once the doctor or nurse has taken some cells they will remove the speculum and you will be able to get dressed.

The cells from the cervix will be placed in a tube that contains liquid before the doctor or nurse sends them to a laboratory for a closer look. The cells are checked for HPV which, if left untreated, can lead to abnormal cells, and, in rare cases, to cervical cancer.

Getting your results

It usually takes around two weeks to get your results. Ask your doctor of health provider when they expect to get them back.

The next step

If HPV is not detected, all you need to do is to come back in five years for your next Cervical Screening Test. You will receive an invitation from the National Screening Register to remind you (unless you have asked for your details to be removed from the register).

If HPV is found, additional tests will automatically be done on the same sample of cells in the laboratory. Your doctor will let you know what will happen next. Depending on the results of all of the tests, you might have a repeat Cervical Screening Test in 12 months, to see if the HPV infection has cleared, or might have a follow-up procedure called a colposcopy.

It's important to remember that HPV infections usually clear on their own. Also keep in mind that most abnormal cells are not cervical cancer, and can usually be treated quickly and painlessly.

You can find more information about the test here.


Isn’t five years too long to wait between tests?

Research has found that waiting five years between tests is very safe for women with a negative HPV result. Because the new screening test finds HPV and not just abnormal cells, it can pick up changes earlier than the Pap smear test. This means it doesn’t need to be done as often.

Women who test negative for HPV have a very low risk of developing cervical abnormalities that may lead to cervical cancer over the next five years. It can take 10 years or more between getting the HPV infection and the infection turning into cervical cancer, so even if you were infected the day after your HPV test, it’s extremely unlikely the infection would progress to cancer before your next test. It’s very likely your body’s immune system would clear the virus itself in that time – but if it didn’t,  it would be picked up at your next cervical screening test.

Aggressive, fast-growing cancers are very rare and are not usually picked up by any screening tests – these are usually diagnosed when women see a doctor after noticing symptoms. All screening programs are designed for women without symptoms.

If you do have symptoms such as abnormal vaginal bleeding or pain, you should see a doctor – it doesn’t matter how old you are or how long it’s been since your last cervical screening test. 

Claire

Claire’s story

“I can’t stress enough how important it is that women go for their tests regularly. If I hadn’t, I may not even have survived to tell my story. It’s just a few minutes of embarrassment for something that could save your life”


What if I’m already vaccinated?

There are a few reasons why it’s important to still have regular Cervical Screening Tests even if you have had the HPV vaccine (Gardasil).

Firstly,  the HPV vaccine only protects against some types of HPV. There are several other types of HPV not covered by the vaccine that can cause cervical cancer.

There is also the chance that you may have been exposed to HPV through sexual activity before you had the vaccine. The HPV vaccine doesn’t treat HPV infections you already have.

In addition, you can still have an abnormal HPV screening test result after you have had the vaccine.

For more information about the HPV vaccine, download HPV vaccine fact sheet or visit the HPV Vaccine website.

What if I’m pregnant?

Pregnant women who are due for a Cervical Screening Test should still be screened. It it safe to be screened in pregnancy, and HPV tests have not been linked to increased rates of miscarriage.

It can be a good time to have a HPV screening test in the early stages of pregnancy, while you are being examined by your doctor for other matters relating to your pregnancy. It can be hard to make time for your own health after your baby is born, so it can be helpful to get the test done before the baby’s arrival.

If you choose to have a HPV screening test after the birth of your baby, it is best to wait at least six weeks –  it is ideal to wait three months. If you have a screening test too soon after the delivery there is an increased rate of unsatisfactory results – for instance, there may not be enough cells in the sample taken, or the cells of the cervix may still be inflamed after the pregnancy and birth.


What if I’ve had a hysterectomy?

 Some women who have had a hysterectomy may need to keep having cervical screening. It depends on the type of hysterectomy, the reason for the hysterectomy, and the woman's cervical screening history prior to the hysterectomy surgery.

Women still need regular screening tests if they have a cervix (if they had a sub-total hysterectomy or partial hysterectomy).

Women without a cervix (who had a total hysterectomy) may still need follow-up tests (using a cell sample taken from the top of the vagina) if they:

  • have not been screened before

  • had a hysterectomy as part of treatment for high grade cervical abnormalities

  • are under surveillance for a previous high grade cervical abnormality

  • have cervical abnormalities detected during their hysterectomy.

If you have had a hysterectomy, ask your doctor whether you still need to have cervical cancer screening.


What if I’m over 50?

The risk of cervical cancer increases with age, so it is important for women to continue having regular HPV screening tests until they are in their 70s.

About half of all cases of cervical cancer occur in women older than 50 years, yet many women over this age think they are not at risk.

Research by the Australian Institute of Health and Welfare (AIHW) shows that:

  • older women are still at risk of cervical cancer

  • women over 50 are far more likely than younger women to die from cervical cancer

  • from 2012-2014, 74% of cervical cancer deaths were in women aged over 50 years.

What if I’m over 70?

Women over 70 still need to have regular cervical screening tests:

  • even if they are no longer sexually active

  • after menopause

  • after a hysterectomy, in some cases.

Women aged 70-74 will be invited to have an ‘exit’ Cervical Screening Test. If HPV is not detected, the risk of developing cervical cancer is very low, and you can stop having Cervical Screening Tests.

If you have not had regular screening tests or have had abnormal results from recent screening tests, you may need to keep having tests for a few more years. Ask your doctor or nurse for advice.

Understanding the test in your language

It has been shown that women from different cultural backgrounds are less likely to have regular cervical screening.

But it’s very important that all women, no matter what language they speak or how long they have been in Australia, have Cervical Screening Tests every five years between the ages of 25 and 70.

Information about Cervical Screening Tests and preventing cervical cancer is available in languages other than English.

You can ask your doctor or health professional about cervical screening, or call the Translating and Interpreting Service on 13 14 50 to speak to a Cancer Council nurse in your preferred language.

Information for Aboriginal and Torres Strait Islander women

It is very important that all Aboriginal and Torres Strait Islander women have a Cervical Screening Test every five years between the ages of 25 and 70.

You should have a Cervical Screening Test even if you feel healthy. This is because cervical cancer and HPV infections usually have no symptoms.

You can go to these places for a Cervical Screening Test:

  • your doctor

  • an Aboriginal Health Service

  • some women's and community health centres

  • Well Women's Clinics and Services at hospitals

Ask your doctor, nurse or Aboriginal health worker when and how you can get the test and your results. Remember, most Cervical Screening Test results are normal, but you need to have the test to make sure.


Information for women with disabilities

All women need to have Cervical Screening Tests every five years between the ages of 25 and 70 if they have ever been sexually active.

Some women with disabilities may face barriers which make having a Cervical Screening Test harder to do. These barries may include things like less transport options to get to a clinic, hardship in accessing clinic facilities, or difficulty understanding the test, what needs to be done, and the results. A doctor or health professional can provide individual advice to help overcome these barriers.

You can also find a Cervical Screening Provider that offers disability access using the following resources:

Information for LGBTIQ people

 

LGBTIQ people aged between 25 and 70 with a cervix need cervical screening, because no matter who you have had as a sexual partner, you're still at risk of cervical cancer.

What do I need to tell my doctor or nurse?

When you have your cervical screening appointment, you may be asked questions such as 'Are you sexually active?' and 'What form of contraception are you using?'. These questions and assumptions can be uncomfortable, so it's a good idea to think about how you would like to respond beforehand.

Choosing a health professional you are comfortable with is important, as they should use language that acknowledges diversity.

The choice to disclose information about your sexuality and gender identity is yours. However, disclosing this personal information may lead to a better experience because the doctor or nurse will be able to tailor your care based on how you identify.

If you choose to disclose, let your health professional know whether or not you want it recorded, as other professionals could have access to your medical records.

Health professionals are required by law to protect your confidentiality and maintain your privacy. 

How do I find the right doctor or nurse?

Finding a health professional who understands the barriers LGBTIQ people with a cervix may face when seeking cervical screening may be challenging.

You can talk to friends to get recommendations of cervical screening providers that are a good fit, or you can find a list of health professionals recommended by members of the LGBTIQ community at DocLIST.

What do I do if I feel discriminated against or uncomfortable during screening?

Health professionals are encouraged to take a sensitive approach when asking about your sexual history and performing pelvic examinations, and are generally informed about LGBTIQ health issues.

Occasionally a person may have a bad experience when having a Cervical Screening Test. If this happens to you, remember that you can stop the test or leave at any point during the consultation.

It's unlawful to discriminate against someone because of their sexual orientation, gender identity or lawful sexual activity (Equal Opportunity Act 2010). If you feel you have been discriminated against, sexually harassed, victimised or vilified, you or someone on your behalf can make a complaint to the Human Rights Commission. If you've had a bad experience but don't want to make a complaint, talk it over with friends or with someone who can offer you support. You can also speak to Cancer Council on 13 11 20.


What if I’m a victim or survivor of sexual assault?

Research shows that some women who have faced sexual assault are reminded of the experience by gynaecological procedures such as the Cervical Screening Test, and may be more likely to avoid regular cervical screening.

Women who are victims/survivors of sexual assault may feel more comfortable seeing a healthcare professional with specialised knowledge in this area.

You may also be eligible for self collection. Speak to your doctor or health professional for more information.

What does my test result mean?

There are four possible results from the cervical screening process, all of which require different action to be taken. These are:

  • Low risk (HPV not detected): This means that no high-risk (cancer causing) HPV was found on your cervix. The chance of developing cervical cell changes that would need treatment in the next five years are very low. For that reason, you should wait for five years before having another cervical screening test.
  • Intermediate risk: Your results show that you do NOT have HPV types 16 or 18 (the highest risk types), but that you have one of the other high-risk HPV types. Your sample will already have been examined in the laboratory to look for abnormal cell changes, and you have either no cell changes or only minor (low-grade) cell changes on your cervix. You will be asked to return in 12 months for a follow-up HPV test, as the infection (and any cell changes) will usually be cleared by your body in this time.
  • Higher risk: Your test results show either HPV infection with types 16 and/or 18, high grade cell changes on your cervix, or persistent infection with one of the other high-risk HPV types (not 16/18). It is important that you have a further follow-up because you may be at a high risk of developing cervical cancer.
  • Unsatisfactory: An unsatisfactory test result occurs when the sample cannot be properly examined. There are a number of reasons why this may happen – for example, the number of cells may be too small, or there may not be enough liquid to perform all the tests needed. An unsatisfactory result does not mean there is an abnormality or a positive test, but it is important to repeat a test at the recommended time.
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How will I be diagnosed further?

If your screening test comes back with any abnormalities or the presence of high-risk HPV types, you may be referred to a specialist.

You can find more information on abnormalities and follow-up here.

The usual tests to diagnose or rule out cervical cancer include:

Colposcopy

A colposcopy identifies where abnormal cells are located in the cervix, and what they look like. During the procedure, a speculum will be inserted into your vagina so the doctor can view the cervix and vagina via a colposcope, a medical instrument that magnifies parts of the cervix, like binoculars.  The colposcope is not put inside your body.

Biopsy, cone biopsy, or large loop excision of the transformation zone

A biopsy is when the doctor removes some tissue from the surface of the cervix and sends it to a laboratory for examination under a microscope. The biopsy may be done during the colposcopy.

What about my partner?

You can have HPV for a long time without ever knowing it. HPV can stay in the body for 10-20 years. Finding out you have HPV doesn't mean you or your partner have has been unfaithful.

It's your decision whether or not to tell your partner you have HPV.

If you do decide to tell your partner you have HPV, it might help to include these points:

  • HPV is very common in women and men who have ever had sex – four out of five people will have HPV at some point in their lives, and most won't even know it

  • there is no treatment for HPV, and in most cases, HPV leaves the body naturally

  • you can have HPV for a long time without ever knowing it, finding out you have HPV doesn't mean you or your partner have has been unfaithful

  • it is difficult to know who gave you HPV, both because the virus is so common and because it can remain dormant in cells for more than 10 years before becoming active

  • there is no reason to stop having sex because you have HPV.

If you have genital warts as a result of the infection, you may choose to discuss this with your partner as he/she is at risk of developing them as well. Genital warts can be treated.


Does HPV affect men?

HPV can affect men as well. The virus causes 95% of anal cancer, about 64% of oropharyngeal (tonsils, throat, base of tongue) cancers, and rarer cancers, such as penile cancers.

There is currently no approved screening test for HPV in men. If a man is concerned or has any questions, he should speak to his doctor or medical practitioner.

We recommend that parents and carers give permission to have both their daughters and sons vaccinated at age 12-13 – it’s the best way to help prevent HPV-related cancers in the future.