Everything You Need To Know About Your First Cervical Screen

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* The following information relates to the National Cervical Screening Program in Australia *

What is it for?

The Cervical Screening Test takes cells from your cervix and tests for the Human Papillomavirus (HPV). 

HPV is an extremely common virus that spreads through sexual activity (this includes all types of sexual activity such as intercourse, oral, anal, hand jobs, etc). While many people who get HPV do not get cancer, HPV can go on to cause some types including cervical cancer.

By having a Cervical Screening Test every five years, you are putting yourself in a great position where you can check to see if you have been infected, and if so, monitor for any changes that may require treatment!

Cervical cancer is one of the most preventable cancers and as stated by Cancer Council Australia “80% of women who develop cervical cancer, have never been screened or have not been screened regularly.”

 

Do I need the screen if I have had the HPV vaccine?

Yes! You still need the screen. The HPV vaccine protects you from some strains that can cause several cancers including cervical, vaginal, vulval, anal, throat and penile. It does not protect you from all types of HPV and therefore you still need regular cervical screen tests!

 

Where is the cervix?

Your cervix is located at the lowest part of your uterus or the top ‘end’ of your vagina. 

The cervix produces cervical mucus that changes in consistency during the menstrual cycle to prevent or to promote pregnancy! Your cervix allows your menstrual blood to pass out of the uterus and through the vagina, and for sperm to travel through the vagina and into your uterus during sexual intercourse. At the end of pregnancy, it widens and opens for the baby to pass through.

Diagram of the uterus 

(Department of Health, 2020)

Making the appointment:

Women and adults with a uterus need to have a cervical screening test every 5 years from the age of 25. 

When booking over the phone or online it may be best to outline that you are coming in for a “cervical screening test” to ensure that the doctor can be prepared and allocate the appropriate amount of time for you. If you prefer a female doctor – ask! The most important thing is that you feel comfortable during the appointment.  

 

On the day:

If you’re feeling nervous before the appointment it is still important that you go. It may be helpful to engage in some calming or mindful activities before the appointment.

Once you arrive do not hesitate to voice any concerns or fears to your doctor. 

When you are ready, the doctor will ask you to remove your pants and lie on the bed with your knees bent and feet on the bed. They might give you a sheet to lie across your stomach and thighs so that you are more covered. Don’t worry – they do not care if you have had a bikini wax or have come full bush.

The doctor or nurse will then insert a speculum into your vagina so that they can see your cervix. They may put a condom or some lubricant onto the speculum to make it easier and more comfortable to be inserted. For some women, this part of the test may feel uncomfortable or embarrassing but just remember that this is a regular part of the doctors job! While the doctor is prepping the speculum it may be helpful to take some calming deep breaths to relax the muscles around your vulva.

Once the speculum is in place and open, the doctor will insert a brush through it and take a swab of cells from your cervix. This can feel a little uncomfortable but it should never hurt. If you feel any pain, tell your doctor immediately. The doctor might even use a torch or light so that they can see your cervix better. This whole process generally takes one to two minutes. The doctor will remove the speculum and you’ll be able to get dressed again.

From here, the swab will be placed in a tube and sent to a laboratory for a closer look.

Illustration of a swab of cells being taken from the cervix.  (Queensland Health, 2018)

What happens next? 

If HPV is not detected you will need to come back in 5 years’ time for your next cervical screen.

If your results come back as positive your doctor will talk about the next steps with you. Often HPV infections usually clear up on their own and you might just have a repeat cervical screen in 12 months’ time (rather than 5 years) to see if it has gone away. Alternatively, you might have other tests or a follow up procedure called a colposcopy.

It is important to remember that most HPV infections usually clear up on their own and very rarely cause abnormalities or cancer.

 

Is a cervical screen the same thing as a pap smear? 

In December 2017 the National Cervical Screening Program changed. Prior to this, women and adults with uterus’ were advised to have a pap smear every 2 years. The pap smear test previously looked for changes in cervical cells that may have occurred as a result of HPV infection. The new test tests for the HPV infection itself. This means that your doctor can monitor HPV if you have a positive result and intervene if there are any chances to cells in your cervix.

The reason that the age has changed from 18 to 25 years old is that most women and people with uterus’ under 25 have had the HPV vaccination and cervical cancer in women under 25 years old is very rare.

  

For more information visit: 

http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/about-the-new-test

https://www.cancer.org.au/cervicalscreening

https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/understanding-your-cervical-screening-test-results

https://www.health.qld.gov.au/news-events/news/everything-that-happens-during-your-cervical-screen

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Jessica Oddi (@oddi.jessica) is a disabled graphic designer in Canada with versatility to spare. She is particularly interested in collaborations involving much needed representation, inclusivity and empowerment. 

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