Prevention

Since 1991, Australian women and people with a cervix have been able to participate in cervical screening through the National Cervical Screening Program. The program changed on December 1, 2017. The Pap test has been replaced by the HPV Test, or Cervical Screening Test (also referred to as CST). These changes are a result of new evidence and better technology to help improve early detection of cervical cancer and save lives. The new Cervical Screening Test detects human papillomavirus (HPV), which can lead to cell changes in the cervix and causes almost all cases of cervical cancer.

Cervical Screening Tests remain your best protection against cervical cancer. The current guidelines recommend that every woman and person with a cervix from the ages of 25-74 who has ever had sex should have a Cervical Screening Test every five years even if you have:

• had the HPV vaccine
• only had one sexual partner
• not been sexually active for a long time
• been in a long term monogamous relationship
• never had sex with a person who has a penis
• been through menopause

If you’ve had a hysterectomy, check with your doctor about your screening needs. Depending on the type of hysterectomy and your medical and screening history, you may need to continue to undertake a type of screening.

If you are under 25 please click here.

Currently, nearly 45% of Australian women are not up to date with their Cervical Screening Tests. This is alarming as evidence shows the women most likely to get cervical cancer in Australia are those who have not had regular cervical screening.

To assist you to remember to have your Cervical Screening Test when you are due, please sign up to our Get the Text service to receive a free SMS reminder.

Your GP or health professional should let you know if you need to have them more regularly. It is also 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.

To make an appointment with a health professional to have a Cervical Screening Test, you can contact:

• your general practitioner or practice nurse
• a community or women’s health centre
• a family planning or sexual health clinic
• a women’s health nurse
• an Aboriginal Medical Service

Schedule your appointment at any time in the month when you aren’t having your period. It is good to write down any questions or concerns you have so you remember to mention them. On the day when you choose what to wear, keep in mind that you will be required to remove your clothing from the waist down so you can be examined. It is a good idea to empty your bladder prior to the procedure for your comfort. 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.

Check out our comfort checklist to find out more about how to make it a comfortable experience.

A Cervical Screening Test (CST) is a relatively simple procedure that  only takes a few minutes and should not be painful. Prior to the procedure your health professional will most likely ask you about your last period, when it began and its duration.  They may also ask if you are using contraception and which method you use. You will be asked to remove your clothing from the waist down and lie on your back or side. You should be given a sheet to cover your stomach and thighs to make you feel more comfortable. When you are ready, your health professional will ask you to bend your knees so they can insert an instrument called a speculum into your vagina. The speculum can be plastic or metal and holds the walls of the vagina open, allowing a clear view of the cervix. This part of the exam can feel slightly uncomfortable or awkward, as there may be some pressure on your pelvic area, but it shouldn’t be painful. If you do feel any pain let your health professional know and they can adjust the speculum. They will then use a small brush to gently collect a swab from the cervix. The cells collected on the swab are then sent off to a lab for examination to check for the presence of human papillomavirus (HPV). And that’s it! You can go about your day. The exam doesn’t prevent any activity afterwards. You may have slight spotting after the test, however if you have any pain or heavy bleeding then it is best to let your health professional know.

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.

Instead of screening conducted by a health professional, self-collection is available if you’re aged 30 years and over and either:

• have never had a cervical screening test or,
• are overdue for a test by at least 2 years.

You need to talk to your health professional to arrange this option. They will talk to you about how to take the sample. You can then take the sample yourself in private, or with help from your doctor, nurse or health worker while at a health facility.

Changes to self collection are due in July 2022, but it is important to ensure you don’t put off your screening if you are due before this date or have never been screened.

The results of your Cervical Screening Test will usually be available within two weeks. You can either schedule a follow up appointment or call your health professional for the results. Your results will also be automatically sent to the National Cancer Screening Register who keep a record of your screening history and contact you by post if you are overdue for your next test. If you do not wish for this to occur speak to your provider when you have your Cervical Screening Test. Find out what different results mean here

Cervical cancer affects lesbian, bisexual, queer and pansexual women. Cervical cancer also affects transmen and non-binary people with a cervix. 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. Here we look to address any queries about cervical screening for the LGBTQI community.

What if I have never had sex with a man or person with a penis?

Human papillomavirus (HPV), the virus that causes almost all cervical cancers, 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.

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 .

Where can I get further information to prepare?

• Review information on Cervical Screening so you know what to expect. Here is a helpful resource made by LGBTQI people for LGBTQI people people https://www.theinnercircle.org.au/guide-to-cervical-screening  .
• 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. Here is a letter you can complete to give your GP https://www.theinnercircle.org.au/letter-for-your-gp/

What can I do if I feel uncomfortable or I am being 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 friend or support person can be helpful if you do not wish to make a complaint.

Our world has changed since COVID-19 and we understand people are concerned about their wellbeing and health risks when attending medical appointments.

The good news is that across Australia screening programs have adapted to ensure the safety of all patients.

Your GP or health professional should meet CovidSafe guidelines and have the correct practices in place to protect against the transmission of COVID-19, including:

• ensuring everyone is wearing a face mask where mandatory
• practicing physical distancing
• low contact check-in process
• providing hand sanitiser and extra cleaning measures
• ensuring everyone is wearing a face mask where mandatory

There are also a number of things you can do to help keep yourself and others safe such as:

• asking about what you need to do when you make the appointment
• attending your appointment alone if possible
• arriving no more than five minutes early
• practicing good hygiene, including hand washing
• keeping a distance of 1.5 metres from others
• staying home if unwell but make sure you reschedule your appointment.

When you book your Cervical Screening Test appointment, ask your clinic what measures they have in place to keep you COVID safe.

I have specific health needs: how can these affect Cervical Screening Test?

It is important to see a health professional regarding specific health needs such as information on pregnancy, early sexual intercourse, sexual abuse, immune-deficiency and DES exposure.

Why was the National Cervical Screening Program changed?

From 1 December 2017, evidence based changes to the National Cervical Screening Program, together with HPV vaccination, were made to reduce the number of cervical cancers by at least an additional 15 per cent. A primary HPV test every 5 years can save more lives and women will need fewer tests compared to the former 2 yearly Pap test program. These changes ensure that Australia stays at the forefront of cervical cancer prevention.

How does the Cervical Screening Test work?

The Cervical Screening Test detects human papillomavirus (HPV) infection, which is the first step in developing cervical cancer. Persistent HPV infections can cause abnormal cell changes that may lead to cervical cancer. However, this usually takes a long time, often more than 10 years from initial HPV infection. While the old Pap test could detect abnormal cell changes, the Cervical Screening Test will detect the persistent HPV infection that causes the abnormal cell changes, prior to the development of cancer. The procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap smear. A doctor or nurse takes a small sample of cells from the woman’s cervix to send away to a laboratory to be examined.

Why should I start cervical screening at 25 years of age?

Cervical cancer is rare under 25 years of age. Research has shown that screening before the age of 25 has not changed the number of cases of cervical cancer or deaths. In addition, investigating and treating common cervical abnormalities under age 25 that would usually resolve by themselves can increase the risk of pregnancy complications later in life. HPV vaccination has already been shown to reduce cervical abnormalities in those younger than 25 years of age and will continue to reduce the risk of cervical abnormalities in this age group.

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. If you are over 70 years old and have never had a Cervical Screening Test, you can make an appointment to be screened.

Will cervical screening prevent all cervical cancers?

There are some rare neuroendocrine cervical cancers that are not caused by HPV. This means they won’t be detected through routine cervical screening tests.

I am HPV vaccinated, so why do I need to have cervical screening tests?

The current HPV vaccine provides protection against about 90% of cervical cancers so it is important that even if you are vaccinated, you are also screened for cervical cancer as you do not have 100% protection.