December marks the launch of the new national cervical screening program in Australia, and here is what you need to know.
The traditional PAP smear has been replaced with a new test – the cervical screening test CST. Before getting too excited the collection method is still the same – we are not saying goodbye to the trusty speculum. The changes in the test are largely laboratory based, but the good news is it will now be a 5-yearly screening test.
Here are the new guidelines
Screening will start age 25 in sexually active females
The last test will be between age 70-74
Women will be recalled every 5 years if their tests are negative
For those of you who like some science behind your medicine:
The CST is a laboratory test looking for oncogenic (cancer causing) strains of Human Papilloma Virus (HPV). 70-80% of cervical cancers are caused by HPV type 16 and 18, there are another 12 oncogenic strains which will be tested for. All women who are positive for HPV 16/18 on their screening test will be recommended to have a colposcopy by a gynaecologist – further testing of the cervix for evidence of cancer. Those samples which are positive for the other HPV types will be sent for cytology – a detailed look at the cells in the sample for any evidence of precancerous or cancerous changes.
So… why are we changing and is it safe to start screening at 25?
HPV infection is very common in young women and overwhelmingly regresses. 80% of women in this age group will have had at least 1 dose of the HPV vaccine.
Acute infection with non-oncogenic HPV can result in high grade changes being seen on the traditional PAP and result in these women having unnecessary and invasive procedures.
Starting screening at 25 will reduce this over treatment and the significant side effects associated with such treatments such as bleeding, infection and complications with future pregnancies.
The PAP has served us well but it is time to come into line with recommendations from the International Agency for Cancer Research and take on the new research which shows us that an HPV test at 5 yearly intervals is safer than a PAP test at 2 yearly intervals.
This article was written by Dr. Susan Cann, and published in the Western Suburbs Weekly.