Screening for cervical cancer
Screening is organised testing to find cancer in people before any symptoms appear. The cervical screening test finds cancer-causing types of HPV in a sample of cells taken from the cervix. This test replaced the Pap test in 2017.
Learn more about:
The National Cervical Screening Program
The National Cervical Screening Program recommends that women start cervical screening at age 25 and then have a cervical screening test every five years up to the age of 74. Whether you identify as straight, lesbian, gay, bisexual, transgender or intersex, if you have a cervix you need to have regular cervical screening tests.
During the test, a doctor or nurse gently inserts an instrument called a speculum into the vagina to get a clear view of the cervix. They will then use a brush or spatula to remove some cells from the surface of the cervix. This can feel slightly uncomfortable, but it usually takes only a minute or two. The sample is placed into a small container of liquid and sent to a laboratory to check for HPV. If HPV is found, a specialist doctor called a pathologist will do an additional test on the sample to check for cell abnormalities. This is called liquid-based cytology (LBC).
The test results are used to predict your level of risk for significant cervical changes. If the results show:
- a higher risk – your GP will refer you for a colposcopy
- an intermediate risk – you will be monitored for changes by having a follow-up test for HPV in 12 months
- a low risk – you will be due for your next cervical screening test in five years.
A small number of women are diagnosed with cervical cancer because of an abnormal cervical screening test. For more information about screening tests, call Cancer Council 13 11 20 or visit cervicalscreening.org.au.
Sometimes the squamous cells and glandular cells in the cervix start to change. They no longer appear normal when they are examined under a microscope.
These early cervical cell changes may be precancerous. This means there is an area of abnormal tissue (a lesion) that is not cancer, but may lead to cancer. Some women with precancerous changes of the cervix will develop cervical cancer, so it is important to investigate any changes.
How precancerous cell changes start
Precancerous cervical cell changes are caused by some types of the human papillomavirus (HPV). HPV and cervical cell changes don’t cause symptoms but can be found during a routine cervical screening test.
Types of cervical cell changes
Abnormal squamous cells – These are called squamous intraepithelial lesions (SIL). They can be classified as either low grade (LSIL) or high grade (HSIL).
SIL used to be called cervical intraepithelial neoplasia (CIN), which was graded according to how deep the abnormal cells were within the surface of the cervix:
- LSIL, previously graded as CIN 1, usually disappear without treatment.
- HSIL, previously graded as CIN 2 or 3, are precancerous. High-grade abnormalities have the potential to develop into early cervical cancer over 10–15 years if they are not found and treated.
Abnormal glandular cells – These can be either low grade or high grade. High grade changes are called adenocarcinoma in situ (AIS or ACIS). They will need treatment to reduce the chance they develop into adenocarcinoma.
Treating precancerous cervical cell changes
Finding and treating precancerous cervical cell changes will prevent them developing into cervical cancer. Read more about how precancerous cervical cell changes are treated.
Podcast for people affected by cancer
Dr Pearly Khaw, Lead Radiation Oncologist, Gynae-Tumour Stream, Peter MacCallum Cancer Centre, VIC; Dr Deborah Neesham, Gynaecological Oncologist, The Royal Women’s Hospital and Frances Perry House, VIC; Kate Barber, 13 11 20 Consultant, VIC; Dr Alison Davis, Medical Oncologist, Canberra Hospital, ACT; Krystle Drewitt, Consumer; Shannon Philp, Nurse Practitioner, Gynaecological Oncology, Chris O’Brien Lifehouse and The University of Sydney Susan Wakil School of Nursing and Midwifery, NSW; Dr Robyn Sayer, Gynaecological Oncologist Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Megan Smith, Senior Research Fellow, Cancer Council NSW; Melissa Whalen, Consumer.
We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
View the Cancer Council NSW editorial policy.
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