Cervical Cancer and Screening
Here are a few facts about cervical cancer:
- In Australia there are about 1000 cases of cervical cancer diagnosed each year.
- Cervical cancer is almost ALWAYS caused by a virus called Human Papilloma Virus or HPV.
- HPV is a group of hundreds of similar viruses that are sexually transmitted. It is very common and most strains are completely harmless.
- There are a two nasty strains of HPV (16 and 18) that increase the risk of cervical cancers (and anal cancers!)
- We now vaccinate against these strains with the vaccine Gardasil. If you are vaccinated against HPV then your risk of cervical cancer is very low.
- Gardasil has been part of the school vaccination program since 2007, and since then the rates of cervical cancer have dropped.
- The vaccine is expected to prevent up to 90% of cervical cancers.
- Cervical cancer can cause symptoms such as abnormal vaginal bleeding after sex, between your periods, or after menopause. It can also cause pain with sex. If you ever have these symptoms, talk to your doctor.
So how do we detect cervical cancer?
Things have changed a bit in the last few years when it comes to cervical cancer screening tests and pap Smears. You might have noticed that you’re being asked to check in for a pap smear every 5 years now, instead of every 2 years.
We used to look for cervical cancer by taking a sample of the cells from the cervix using a brush and looking at them under the microscope to see if there are any cancer changes (a process called the Pap smear). To make sure any new changes would be caught, we used to suggest women got Pap smears every 2 years.
Fun fact: a pap smear gets it’s name after Dr Papanicolaou who first developed the smear test in the 1950s
Since 2017, we now also look for fragments of cancer-causing HPV on the cervix to work out if someone is high or low risk of developing cervical cancer in the future. This is called a Cervical Screening Test (or CST). A CST is still the same process as a Pap smear; a speculum is inserted into the vagina, and a brush sample of the cervix is taken. Detecting HPV on the cervix means we can work out who is low, medium and high risk of developing cervical cancer well BEFORE there are any cancer changes in the cells!
If no HPV is detected on your CST then you’re very low risk of developing a cervical cancer and you don’t need another test for 5 years (how good!).
If you have any kind of HPV detected, the cells will be checked for any abnormal changes, and you will need to repeat your test in 12 months time.
If you have HPV 16 or 18 detected, the cells will be checked for abnormal changes and you’ll be sent to a gynaecologist for more testing. Usually this is for a test called a colposcopy where the cervix is looked at with a microscope to see if there are any areas have cancer changes.
If you have had previous cervical cancer or pre-cancer changes that have been treated, OR if you have any symptoms that could be concerning for cervical cancer (like abnormal vaginal bleeding or pain after sex), make sure you talk to your doctor to make sure you’re getting the right testing and follow up!