Cervical Screening

Dr Suresh Khirwadkar discusses changes to the Cervical Screening Program in Australia on his channel The Honest Doctor

There are changes to the cervical screening program in Australia. It is now 5 yearly rather than every 2 years, and is up to 30% more accurate than the previous test.

Changes to the program

Otherwise known as Pap Smears, The Cervical Screening Test (CST) has changed. It changed around 2 years ago in Australia and is now primarily testing HPV (human papilloma virus), mainly strains 16 and 18, although it can pick up other strains.

It is theoretically more effective than the previous test by around 30%, and as a bonus is a 5 yearly test rather than every 2 years like it was previously.

Cervical screening is now done usually from 25 up until age 74, rather than the previous 18-69. This brings it inline with most of the rest of the world. It is from age 25 because below this age there is a high chance you can pick up cells that may appear abnormal but actually are harmless. This unfortunately can lead to procedures and investigations that do carry risks, including risks to sex and fertility and pregnancy later in life. You can still get screening before age 25 if you really want, but it can increase the risk of issues and would be a private fee (in Australia) as Medicare does not pay for it below age 25.

what if i have symptoms down below?

The CST is a screening test so by definition patients do not have symptoms. If you have symptoms you may need a similar exam and test but the lab test will be slightly different. Please speak to your GP if you have any vaginal symptoms or concerns otherwise.

Cervical screening is not a pleasant thing to have done but is essential and is one of the best screening programs we have so do make sure you go get it done.

What does the test involve?

Well sorry ladies, there’s just no way around it, it involves an intimate examination of the vagina and cervix. It does not usually need a digital vaginal examination, but if your doctor has concerns they may recommend this to you at the time.

The test involves using the speculum to open up the vagina so the doctor can see and inspect the cervix and then take the small sample of cells from the area.

There may be a little bleeding afterwards and this is common, but heavy bleeding is unusual and you should see your GP if this occurs. Likewise minor period like cramps often occur but heavy pains you should see your GP asap.

My doctor struggled to find my cervix

Unfortunately this is common. Sometimes the cervix is difficult to find, even by the most experienced doctor. It doesn’t mean your doctor doesn’t know what they are doing.

Sometimes your doctor may suggest you raise your bottom off the examination couch and make a fist to sit on, this can help bring the cervix in to view a little. Sometimes they will even ask you to ‘wiggle’ your hips a little which can help. If still struggling they may ask you to return another time or see a colleague (sometimes a fresh pair of eyes does the job). Don’t worry if this happens, it’s common unfortunately.

my doctor is male, can they do my pap?

Probably.

All GPs are capable of doing Cervical Screening Tests (CST) aka Pap Smears, however some are a little out of practice as they don’t do many. Others have chosen to focus on other areas like skin cancer or addiction medicine and so they may feel it would be better to refer you on to another doctor for the test, someone who has more experience in that area. Others do hundreds if not thousands a year and have lots of experience.

Most male doctors I know (including myself) do CSTs on our female patients, but check with your GP first.

My GP is female so she’ll do it

Not necessarily! Not all female GPs do cervical screening tests, for the exact reasons above. Some are highly specialized in other areas and so may refer you on to other doctors including male doctors. Just because your GP has the same bits as you doesn’t mean they will be confident examining them.

Results

Usually results come through within a few days (in Australia), but may take a few weeks. If you don’t get them please make sure you follow up with your GP to discuss as assuming they are normal if they haven’t contacted you could be dangerous – they may be assuming you will contact them!

If you ever aren’t sure of your latest results you can always ring the cervical screening team – information can be found here.

Usually follow up will be 5 yearly but it depends on your results. Your doctor will advise you when you will be next due another CST. If you develop symptoms in the meantime, even if you have just had a normal CST then you should see your GP to discuss as there could be a problem.

Dr Suresh Khirwadkar is a GP and Skin Cancer Doctor in Brisbane. https://drsuresh.com.au