Radical changes made to the National Cervical Screening Program (NCSP) in December 2017 are potentially putting your health at risk. Make sure you are having regular Pap smears!
Since December 2017 the Pap smear has been replaced by the HPV test (a test for human papilloma virus) as the 'front line' tool in preventative cervical screening.
The 'Cervical Screening Test' (CST) offered is not a Pap smear but a HPV test. A Pap smear will only be offered if the HPV test is positive.
Other concerning changes to the NCSP are that a CST is only offered at 5-yearly intervals (previously 2-yearly); and only beginning at age 25 years (previously age 18 years).
Terminology has also changed and the Pap smear is now Liquid-Based Cytology (LBC).
From a woman's perspective, the physical examination remains the same - a scraping of cells is taken from the cervix and sent off for testing. However the difference is that now the sample is sent off to be analysed in terms of HPV status, not cytology to screen for cervical cell changes and abnormalities. If the sample is found to be HPV positive, the same sample is then reanalysed using cytology.
The CST is a HPV test, followed by a cytology test if HPV is found. So, in effect, you only have a Pap smear if you test positive for HPV.
We believe women should be offered a LBC test regardless of HPV status.
Why? HPV is a sexually transmitted infection (STI) that can affect cervical squamous cells causing precancerous squamous abnormalities, termed cervical intraepithelial neoplasia (CIN) or squamous intraepithelial lesions (SIL).
If left undetected and untreated these abnormalities have the potential to progress to squamous cell cervical cancer. Hence the HPV test is a screening tool for squamous cell cervical cancer.
However 30% of cervical cancers diagnosed in Australia are glandular cell cervical cancer (adenocarcinoma), a more aggressive form of cervical cancer.
So while the HPV is a screening tool for squamous cell cervical cancer, it is NOT a screening tool for adenocarcinoma.
The Co-Test
On way around this is to request a co-test – both a HPV test and LBC test.
With a co-test, at the time of examination two samples of cervical cells are taken and placed into two separate containers. One container is sent for cytology (LBC test); and the other container is sent for partial HPV genotyping (HPV test).
Good luck with trying to navigate the disaster that the NCSP has become!!!