HPV & CERVICAL CANCER
Is there a test for HPV?
Yes, it is currently recommended that all women between the ages of 25-74 undertake a routine Cervical Screening Test (HPV Test) every 5 years. Routine cervical screening detects the presence of the human papillomavirus (HPV), prior to the development of abnormal cells, which over a long period of time (up to 10 years) can go on to form cervical cancer.
Routine Cervical Screening Tests are critical to the prevention of cervical cancer. The test is available on the Medicare Benefits Schedule. Currently, there is no routine HPV test available for men.
The National Cervical Screening Program changes are now in effect, for more information about what’s changed read here.
Can you still get HPV if you are a virgin?
Yes you can. Unlike some STI’s HPV is not transmitted via bodily fluids, rather it is transmitted via skin to skin contact. If you are or have been intimate with someone who has been exposed to HPV, there is a chance you could contract HPV even without vaginal or anal penetration. Oral HPV transmission can occur through contact with the mouth or genitals
Can you still get HPV if you wear a condom?
Yes – condoms provide some, but not complete protection against HPV. As HPV is transmitted via skin-to-skin contact rather than bodily fluids, condoms cannot provide full protection from contracting HPV. HPV can also be contracted through any oral and genital contact. The use of condoms are highly encouraged as they provide valuable protection against many STIs and unplanned pregnancy, though their protection against HPV has limitations.
What if I have missed a dose at school?
If you miss a dose at school, and are still in the eligible year level, you can ‘catch up’ that dose for free through a GP or local immunisation provider. If you are 15 to 19 years of age when you get your first dose of HPV vaccine, you will need 3 doses, not 2 doses, to provide the best protection. You will need to pay for one of these doses because only 2 doses are covered under the NIP. This is the case for both boys and girls. Some local council’s provide the vaccine at free clinics to students one year outside of the eligible year level but parents would need to check this with their local council as each varies. Note: all students (under 18) must have parental permission to receive the vaccine.
There is some great information made for parents about HPV and vaccination available from Cancer Council.
Is cervical cancer hereditary?
The majority of cases of cervical cancer develop from contracting the human papillomavirus. As this is a virus you contract; there is currently little evidence that you are any more predisposed to developing cervical cancer if your mother or grandmother had it.
How do people die from cervical cancer?
The source or location of cancerous cells are different for different forms of cancer, therefore treatment is different depending on the type. Normal cells divide a certain number of times before they expire making way for new healthy cells however the cancer cells are immortal. Cell division is rapid as well as unlimited, so these rapidly dividing malignant cells compete with the normal cells for nutrients and oxygen. Ultimately normal cells die off due to nutrition depletion.
Sometimes these cancer cells obstruct certain passages e.g.: Gastro intestinal tract, blood vessel, biliary tract, urinary tract and take nutrients and oxygen. This could ultimately lead to death of the person with the cancerous cells.
Have they found a cure for cervical cancer yet?
Currently, there is no cure for cervical cancer. They are working on a vaccine for women who have already contracted HPV, but it is still a way off. There are effective treatments however such as different types of surgery and chemotherapy that can rid the body of cancer completely, as is the case with all types of cancer. Like most forms of cancer, the effectiveness of these treatments are dependent on the stage and type of the cancer.
How does smoking affect the possibility of getting cancer?
Women who smoke tobacco are about twice as likely as non-smokers to get cervical cancer. Smoking exposes the body to many cancer-causing chemicals that affect organs other than the lungs. These harmful substances are absorbed through the lungs and carried in the bloodstream throughout the body. Tobacco by-products have been found in the cervical mucus of women who smoke. Researchers believe that these substances damage the DNA of cervix cells and may contribute to the development of cervical cancer. Smoking also makes the immune system less effective in fighting HPV infections.
Does cervical cancer treatment affect women’s ability to have kids?
It depends on the case, the degree of the cancer and what is deemed the most appropriate treatment based on a variety of factors. Treatment may be in the form of surgery but not all women with cervical cancer will need major surgery. Removal of the cervix and uterus (hysterectomy) to completely rid the body of cancerous cells may be a part of a treatment program in severe cases of cervical cancer. Factors such as a woman’s age and if they already have children would be considered.
There have been cases of younger women having a radical trachelectomy and pelvic lymphadenectomy, which meant while they have undergone radical surgery they can still have children. Chelsea Farry, one of ACCF’s ambassadors underwent this surgery and tells her story.
CERVICAL SCREENING TEST
How will I know if I have HPV?
Approximately four out of five people will contract HPV at some point in their life. Most of these people will not know that they have contracted the virus and in the majority of cases it will clear up naturally. There are around 100 different types of HPV and some of these can cause ‘low risk symptoms’ such as genital warts. However, the majority, including those that most commonly lead to cervical cancer, do not carry any noticeable symptoms. Most types of HPV will clear up before you even know that you have it.
The most effective way to detect HPV is through having a Cervical Screening Test (or HPV test), 5 yearly or as recommended by your doctor.
I have had a full hysterectomy, do I still need to have a Cervical Screening Test?
It is important, no matter what type of hysterectomy or surgery you have had to discuss your need for future Cervical Screening Tests with your doctor. Women who have had a hysterectomy usually do not require further cervical screenings, however, in some cases, Cervical Screening Tests may still be needed.
Women who have had a total hysterectomy, that is, the uterus and cervix removed, and have ever had treatment for severe changes on the cervix, are recommended to continue to have tests taken from the upper vagina (known as vault smears).
- Women who have had a hysterectomy but have never had a cervical screening should also have a vault smear.
- Women who have had a partial hysterectomy, where the cervix is not removed, should still have a Cervical Screening Test every five years.
Many women do not know exactly what type of hysterectomy they had. If you are not sure, it is important to find out by speaking to your doctor.
I’ve been through menopause; do I still need to have a Cervical Screening Test?
Cervical Screening Tests are recommended every 5 years from the age of 25-74, unless your doctor advises otherwise. The risk of getting cervical cancer is the same even after menopause so it is important to keep having Cervical Screening Tests every five years.
I have specific health needs: how can these affect Cervical Screening Test?
It is important to see a health professional regarding specific health needs. The Cancer Institute NSW provides information on pregnancy, early sexual intercourse, sexual abuse, immune-deficiency and DES exposure.
When should I stop having Cervical Screening Tests?
Cervical Screening Tests are recommended every 5 years from the age of 25-74, unless your doctor advises otherwise. If you are 70 years or over and have had regular Cervical Screening Tests, you will be recommended to have an exit HPV Test, but you can continue to undertake cervical screening if you would like to. Women who are over 70 years who have never had a Cervical Screening Test, or any woman who requests a HPV Test, can make an appointment to be screened.
Where can I go to get a Cervical Screening Test?
- Your general practitioner;
- a community or women’s health centre;
- a family planning or sexual health clinic;
- a women’s health nurse; or
- an Aboriginal Medical Service.
Some women feel uncomfortable seeing their regular GP for a Cervical Screening Test. It is important you find a GP, nurse or clinic you feel comfortable with and it is important to remember that 2 minutes could literally save your life.
LGBTQ AND CERVICAL SCREENING
Cervical cancer affects lesbian, bisexual, queer and pansexual women. Cervical cancer also affects transmen and non-binary people with a cervix. Almost all cervical cancers are caused by the human papillomavirus (HPV). Often known as the common cold of sexually transmissible infections (STIs), 80% of people will contract HPV in their lifetime. The virus is passed on by genital skin-to-skin contact. Unlike other STIs, HPV is not passed on by bodily fluids, semen, saliva or blood.
The National Cervical Screening Program (NCSP) in Australia is available to all people with a cervix between the ages of 25 and 74 who have ever been sexually active. The following FAQs look to address any queries about cervical screening for the LGBTQ community.
What if I have never had sex with a man or person with a penis?
HPV can be transmitted by any kind of sexual contact. Transmission does not require a penis to be involved. Transmission can occur no matter how you identify. As HPV has no symptoms and tests are not conducted on people with a cervix until they are 25 years old, there is always the possibility that a sexual partner could have contracted the virus and passed it on to you without your or their knowledge. HPV is very common so even if you have only had one sexual partner, you need to be screened.
What can I do to lower my chance of developing cervical cancer?
Screening every 5 years from 25 – 74 years. The procedure takes about 5 minutes and gives you peace of mind for 5 years.
Practice safer sex: use dental dams, gloves and condoms (on a penis or dildo) to prevent the transmission of HPV. The use of lube so dams, gloves and condoms don’t break is also helpful.
It is important to check with a medical professional if between tests you have any unusual symptoms* such as:
- unusual bleeding –after sex or between your usual periods
- unusual changes to the colour, smell or amount of vaginal discharge
- pain during or after sexual activity
- warts or other growths, lumps, or sores on your genitals, anus or in the mouth or throat
- pain or discomfort going to the toilet
- painful abdominal cramps or lower back pain – (NB these symptoms are very common for people with a cervix during their period, but if cramping is extremely painful or persistent, you should chat with your doctor.)
*Please note that these symptoms are very general and may not indicate cervical cancer.
What are my options for methods of cervical screening?
Cervical screening can be conducted by:
- A medical professional/doctor or
Screening by a health professional takes only a few minutes. The procedure involves inserting a speculum into your vagina or front hole, to hold it open and make it easier to take a cell sample from your cervix.
You can insert the speculum yourself and then have the cell sample taken by the health professional.
From 1 July 2022, Australia’s National Cervical Screening Program (NCSP) has expanded, offering self-collection as a choice to all women and people with a cervix participating in cervical screening.
All participants aged 25 to 74 will be offered a choice to screen using either:
- a self-collected vaginal sample or
- a clinician-collected sample from the cervix.
Both options are still required to be accessed through a healthcare provider, but self-collection can be done in private without assistance.
How do I find the best doctor to meet my needs?
It is important you can find a medical professional who you feel comfortable with to discuss your cervical screening and other health needs. Your friends may have suggestions or the following links can help you find a provider in your area.
The Australian Lesbian Medical Association (ALMA) compiles an up to date list of doctors and mental health professionals who are recommended by lesbian and bisexual women.
The Australian Professional Association for Trans Health (AusPATH), is Australia’s peak body for professionals involved in the health, rights and well-being of trans, gender diverse and non-binary people. They provide a list of health service providers
By law, health professionals must maintain privacy and confidentiality. If you are happy for your records to be shared with other health professionals they can be added to your My Health Record.
How do I prepare for my Cervical Screening?
Being prepared for your cervical screening is important in case you become nervous when you arrive and leave out any questions or concerns you have. To prepare for your screening:
- Review information on Cervical Screening so you know what to expect. ACON has a great resource on Helping you through the test
- If you are nervous about the screening procedure then write down any questions or concerns you have that you can ask or give to the health professional.
- Wear loose comfortable clothing – you will be asked to remove clothing from the waist down.
- Empty your bladder before you arrive at the clinic or ask to use the toilet when you arrive.
- Try to stay as relaxed as possible – this will help minimise any discomfort. For example, try to take some long slow and deep breaths to maintain a sense of calm.
What should I expect from my health professional?
- An option to have a support person present eg, relative/friend/clinic nurse.
- Prior to the screening – privacy to undress.
- A sheet to drape across your stomach and thighs to minimise exposure and ensure your modesty.
- Easy to understand instructions during the procedure and reassurance. You can ask the doctor/health professional questions and ask them to stop at any time.
- Sterilised medical instruments (presented at a comfortable temperature) – to take a sample.
- Opportunity to insert the speculum yourself.
- At completion of screening – Further privacy to dress & provision of tissues, sanitary pads and handwashing facilities – if needed.
- Answers to any questions you have about the screening, appearance of your reproductive organs, when results will be available, how the results will be communicated with you and any follow up required.
What if abnormalities are detected in screening?
If there are any abnormalities your health professional will be in contact to arrange a subsequent appointment to discuss the findings of the screenings and the next steps to be taken. You can take a support person with you if this will make you more comfortable.
What can I do if I feel I am being uncomfortable or discriminated against during screening?
If you are feeling uncomfortable during the screening process you can ask to stop or pause the procedure. You can ask any questions that may overcome this discomfort and enable the screening to continue, or you can leave at any time you wish.
A person cannot be discriminated against due to their gender identity, sexual orientation or lawful sexual activity (Equal Opportunity Act 2010). If you feel discriminated against, sexually harassed, victimised or vilified, you or someone on your behalf can make a complaint to the Human Rights Commission. Discussion with a friends or support person can be helpful if you do not wish to make a complaint.
This is a comprehensive resource on cervical cancer and screening developed by ACON for LGBTQ people https://canwe.org.au/staying-healthy/cervical-screening/
National Cervical Screening Program – https://www.health.gov.au/initiatives-and-programs/national-cervical-screening-program
More info about ACCF
Phone: 07 3177 1099
Post: PO Box 1008 Fortitude Valley QLD 4006