Cervical Screening Self Collection – What do I need to know?

Recent changes have been introduced to how screening is conducted for cervical cancer. Many women will now be able to perform the test themselves without the need for an internal examination by a doctor. Below, we hope to answer some questions that might arise, explain the changes and what it might mean for you.

What is cervical screening? How does it work?

• Cervical screening is an important public health strategy aimed at the early detection and cure of cervical cancer. It involves taking a sample of fluid and cells from around the cervix.
• You may know it is as the “Pap Smear test”, but the way in which Australian women have undergone testing has changed over the past 5 years to a newer and more accurate test which uses techniques which are different than the traditional Pap Test. For this reason, we now use the term Cervical Screening Test, or CST, instead of pap smear.
• These advances mean that Australian women can now undertake screening every 5 years, instead of every 2 years as it was previously, while increasing the effectiveness of the screening program.
• These newer techniques recognise that the type of cervical cancer for which we screen is caused by the HPV virus and are aimed at detecting the virus. The same swab can also be used to detect small amounts of cancerous or pre-cancerous cells if required and depending on the individual situation.

What causes cervical cancer?

• The type of cervical cancer for which screening is offered (called Squamous Cell Carcinoma) is caused by infection with the Human Papilloma Virus. This accounts for about 90% of cases of cervical cancer.
• Other causes of Cervical cancer (specifically adenocarcinoma) develop less predictably and are not specifically targeted by the screening program. Thankfully, this other type of cancer can still be detected by screening and is one of the reasons why your doctor will ask you a series of questions to see if routine screening is appropriate for you and if you should undergo an examination.

What is HPV?

• HPV (Human Papillomavirus) is a very common virus in humans that manifests in a number of ways. There are a large number of different strains of HPV, only a small number of which can cause cancers.
• The HPV vaccine is included in the National Immunisation Program and offered to all boys and girls in year 7.
• The HPV vaccine (Gardasil) is considered a massive success and source of pride for Australia.
• Australian scientists helped develop the vaccine and Australia was the first country in the world to roll out a national HPV vaccination program in 2006. 6 years later the vaccine was expanded to include teenage boys.
• Australia was also an early adopter of the new screening test and so Australian men and women are amongst the best protected in the world from HPV infection and associated cancers!

So, what are the new changes with the CST?

• Going forward, many people will be able to do their test themselves without an examination.
• This will apply to anyone with a cervix and who has no worrying symptoms, no history of abnormal cervical testing and has no significant risk factors.
• The option will still be there for your doctor to perform the collection if you so wish.
• To do the test, you will be provided with a simple kit and instructions on how to perform the test yourself.
• You will still need to see a doctor to discuss the test and provide you with the appropriate referral.
• If you have had abnormal screening in the past, have had previous cancers or have symptoms such as bleeding or discharge, you will likely be recommended to have a more traditional examination and test with your doctor or nurse*.

*While some nurses have additional training to conduct cervical screening, this service is not currently available at Barwon Heads Family Practice.

What are the benefits of self-collection?

• It is recognised that lots of people find the process of undergoing an intimate examination for the purpose of cervical screening to be confronting and uncomfortable.
• People who don’t undergo regular screening are significantly over-represented amongst those diagnosed with invasive cervical cancer.
• The hope is that self-collection will offer a quick and easy, acceptable alternative to the traditional methods of screening.

Is self-collection safe?

• Yes, self-collection is as accurate as the traditional method for detection of HPV.
• The process of collection is simple and should not cause pain.
• If you have had a previous abnormal test, have symptoms (bleeding, discharge, pain etc) or if you are at increased risk of cervical cancer for another reason then your doctor may recommend an examination and collect the sample themselves.
• The self-collection test is not designed to detect cancer cells and therefore it is not recommended for higher-risk people.

What if I am not confident or comfortable to collect it myself?

• You can absolutely opt to have cervical screening performed by your doctor or at a dedicated sexual health clinic if that is your preference.
• If you are low risk, your doctor can also perform the “self-collection” swab which is performed without an internal examination.
• Chat to your doctor about your options and they will find the right solution for you.

If you have any further questions about cervical screening, book an appointment with one of our doctors who can talk you through the process.