A pap smear or cervical screening is not the most exciting errand, but if you've been putting it off you may have different options this time.
While you may be familiar with the term "pap smear", the test was actually replaced by the cervical screening test back in 2017.
It's not just a new name, the cervical screening test can detect the risk of developing cancer earlier than a pap smear could.
Since 2022, self-collection has been added as an option.
When do you first get a cervical screening?
Judith Hammond — a women's health GP at Jean Hailes for Women's Health — says if you are 25 (or older) and have been sexually active, you are due to start cervical screening, and it should occur every five years.
The National Cervical Screening Program (NCSP) says you're eligible if you're aged between 25 and 74, have ever been sexually active and have a cervix.
Depending on your age, this may have changed. Before the switch to cervical screening in 2017, women aged between 18 and 70 were asked to see a doctor and do a pap test every two years.
Dr Hammond says cervical screening can detect the risk of developing cervical cancer earlier and "the other reason we're not doing cervical screening as frequently is because we're seeing fewer HPV infections because women are having the HPV vaccine".
How to tell when you're due for one?
It can be easy to lose track of when you last had a cervical screening, especially because they are now recommended at five-year intervals
Dr Hammond says you or your doctor can check your screening history via the National Cancer Screening Register.
Chair of the Cancer Council's Cancer Screening and Immunisation Committee, Karen Canfell, says the register also "writes to eligible screening participants to invite them to screen at their preferred primary healthcare provider, usually around three months before their HPV screening test is due".
Reminders are now being sent via text, but you can still opt to get them posted to your address. The register gets your address from Medicare so it may also be worth considering if it's current.
Dr Hammond says you could also help yourself remember by having it done around a significant birthday or someone else's and associate it with that.
If you first have a cervical screening around your 25th birthday, you might remember to get it done in half-decade intervals at 30, 35, 40, she explains.
What does a cervical screening involve?
Self-collection has been available since 2022 and Professor Canfell says it is helping to support "people who might be uncomfortable with direct involvement of a clinician to take control of their screening".
"It's potentially a completely different experience now".
Self-collection is facilitated by a healthcare provider, so you will still need to make a booking.
Dr Hammond says cervical screening is less invasive and faster than the traditional pap smear or pap test.
She says a doctor can do a cervical screening for you, or you can do it yourself, behind the curtain in the consultation room, in the clinic bathroom or you may be able to take the test home.
"You just insert it similar to a COVID test … the swab looks similar, you just insert it into the vagina and give it a bit of a swish around."
Afterwards, Dr Hammond says you pop it back into the tube it came in and it is sent on to be checked for HPV.
Dr Hammond says if you have symptoms such as "bleeding between periods or bleeding after intercourse" the doctor may suggest a liquid-based cytology test (which is very similar to a pap smear), as well as doing the HPV screening.
If your initial screening results warrant further investigation you may also have a liquid-based cytology test as part of the follow-up, she says.
Like a pap smear, Dr Hammond says it involves a speculum (a plastic device that comes in a variety of sizes) sliding into the vagina and collecting a sample.
If you have had negative experiences previously or have any concerns it's helpful to mention them with your doctor beforehand, she says.
Why is cervical screening important?
A cervical screening tests looks for human papillomavirus (HPV), a common sexually transmitted infection.
Dr Hammond says "we now understand that almost all cancer of the cervix is caused by human papillomavirus."
Professor Canfell says there are many different types of HPV and only some have been linked to the abnormal cell changes in the cervix that can become cancer.
"It's really about identifying that a person is at higher risk if they are carrying those types and … making sure that the appropriate follow up and, if necessary, diagnostic examination is conducted from there."
Australia's NCSP began in 1991, and as a result Professor Canfell says "Australia has one of the world's lowest cervical cancer incidence and mortality rates".
"Put simply, participating in the program could save your life"
What are your results likely to look like?
Dr Hammond says it will normally take about two weeks to receive your results.
Professor Canfell says "most people will test negative for HPV and be advised to re-screen again in five years' time up until the age of 74".
However, "some people may receive a positive result for HPV infection and be referred for a follow-up test in a year or so, noting that HPV is a common infection and is often resolved by the body's immune system, with no intervention required".
She says some types of HPV or abnormal cell development may require treatment, which your doctor will talk you through.
This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.
