How common is cervical cancer?
Australia has among the lowest rates of cervical cancer in the developed world. Around 700 women are diagnosed with cervical cancer each year and over 200 die as a result of the disease.
How is cervical cancer diagnosed?
The Pap test (also called Pap smear) is a simple test that detects abnormal or cancerous cervical cells. Because the Pap test can detect cervical changes before they progress to cancer, it is very effective in reducing the number of cervical cancers diagnosed and deaths from the disease. The test involves a doctor or nurse taking a sample of cells from the surface of the cervix that is then smeared onto a glass slide. The slide is sent to a laboratory for analysis and the results are usually available within a week or so.
Most Pap test results are normal. A small number show changes in the cells of the cervix, which are mostly minor infections that usually clear up naturally or are easily treated. In a very small number of cases if the abnormality persists and is left untreated the changes may develop into cervical cancer. When detected early, changes to the cells of the cervix are easily managed.
Who should have a Pap test?
All women who have ever had sex should have a regular Pap test every two years from the ages of 18-20 to 70 years.
What are the current screening interval recommendations and how were they decided?
The National Cervical Screening Program recommends that women be screened every two years. The organised screening program in Australia was initiated in 1991 and followed a 1986 review by a working group of the International Agency for Research on Cancer (IARC) on the effect of screening interval in eight countries. The IARC working group found that 3-yearly screening conferred a substantial level of protection against cervical cancer, but that more frequent screening afforded little further protection.
The choice of a 2-yearly screening interval in Australia was made in the context of the IARC review, while including a safety margin.
How often do Australian women currently get screened?
- 61% of Australian women in the target age group are screened every two years.
- Around 26% of women Australian women with normal Pap results have early re-screening, more often than the recommended two years.
- Up to 12% of Australian women have never been screened for cervical cancer.
- Around 60% of Australian women in Indigenous Communities are not screened every two years.
Have pap tests been effective?
Pap tests have been one of the major success stories of cancer prevention. In just seven years after the initiation of the National Cervical Screening Program the rates of cervical cancer, and the number of women who die from it, dropped by about a third.
Why compare screening intervals?
The discussion about whether Pap tests are recommended every two or every three years in Australia isn’t new. A 1986 review by a working group of the International Agency for Research on Cancer found that 3-yearly screening conferred a substantial level of protection against cervical cancer. And in June 2005, The National Health and Medical Research Council recommended that “screening interval for Pap smears in Australia be reviewed to ensure that the program here is consistent with international best practice.”
What about the recent controversy surrounding screening?
Debate in 2004-2005 was centred on follow-up tests for women with abnormal test results, and wasn’t about recommended screening guidelines for women with normal results. This research is only concerned with screening intervals for women who have a negative Pap test result.
How does Pap screening work in Australia?
Pap Test Registers operate in each State and Territory. They keep a confidential record of Pap tests and related follow-up tests. The registers automatically send out reminder letters to women who are overdue for a test and make sure women with abnormal results get follow-up tests and care. You don’t have to be on the register if you don’t want to be. For enquiries, phone the National Cervical Screening Program in your State or Territory on 13 15 56.
NSW Cervical Screening Program phone 13 15 56, or check http://www.csp.nsw.gov.au
Does the new vaccine mean women can stop having Pap tests?
The HPV vaccine is most effective if given to girls before the initiation of sexual activity. This will substantially lower their risk of developing cervical cancers caused by the most important cancer-causing strains of HPV. However, some risk of cervical cancer will still remain and it is very important for women who have been vaccinated to continue being screened.
For women who have already had sex, regular Pap tests remain critically important to detect abnormal cell changes in the cervix, and they should continue to be tested at the recommended intervals.
Where to have a test?
You can get a test done by your:
- women’s health nurse
- family planning clinic
- sexual health clinic
- community health clinic or women’s health centre
- Aboriginal medical centre