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The Cervical Screening Test (Pap Smear Replacement)

CPD
5m

Published: 14 January 2020

Cover image for article: The Cervical Screening Test (Pap Smear Replacement)

Changes were introduced to the National Cervical Screening Program in December of 2017 as a result of improvements in science, technology and research into how cervical cancer develops.

A primary change was that the cervical screening test replaced the procedure known as the pap smear.

Cervical cancer is one of the most preventable cancers. Routine cervical screening is the best method of protecting oneself against cervical cancer. Avoiding the cervical screening test or being tested less frequently than recommended is a risk factor for developing cervical cancer (Cancer Australia 2017).

cervical screening test
The cervical screening test replaced the procedure known as the pap smear.

What is a Cervical Screening Test?

The cervical screening test is a safe, quick test that can be performed in a few minutes by a doctor, nurse, women’s health centre, community health clinic, or Aboriginal health worker in a clinic or consulting room (NSW Government n.d.).

The cervical screening test is expected to protect almost 30% more people from cervical cancer than the pap smear was able to (Department of Health 2020).

People who have a cervix and are aged 25 to 74 are eligible for the cervical screening test. The cervical screening test is more accurate than the pap smear as it is able to detect the presence of human papillomavirus (HPV), a sexually transmitted infection that is the cause of 99% of cases of cervical cancer (Healthdirect 2018).

It is necessary to undergo the cervical screening test every five years, rather than every two years as was recommended for the pap smear (Department of Health 2020).

It usually takes 10 to 15 years for abnormalities caused by the HPV virus to develop into cancer (Department of Health 2020).

Even if a person has been vaccinated against HPV, they still need to take the cervical screening test. The cervical screening test protects people from certain strains of HPV that cause cancer, but not all (Queensland Health 2018).

diagram of vagina
Diagram of vagina showing location of cervix.

What is HPV?

HPV is a very common virus spread through skin-to-skin contact. Generally, HPV does not have symptoms, though it can cause genital warts (Healthdirect 2018).

It is possible to contract HPV the first time you have sex, even if a condom is used. There are over 100 strains of HPV, and four out of five people have at least one kind of strain of the HPV virus (Healthdirect 2018).

Who Should Take the Cervical Screening Test?

People who:

  • Have a cervix;
  • Are 25 to 74 years of age; and
  • Have been or are currently sexually active.

(Healthdirect 2018)

The cervical screening test is necessary for people who fit these criteria even if they have been vaccinated against HPV or if they identify as lesbian or transgender (Healthdirect 2018).

What to Expect From the Cervical Screening Test

The test is a simple procedure to check the health of a person’s cervix (the entrance to the uterus from the vagina). It is performed in a private room in which the test will be explained to them by a nurse or doctor.

The procedure requires the removal of the individual’s clothing from the waist down and to lie down on a bed with their knees bent and apart. The doctor or nurse will then gently insert a speculum into their vagina to keep it open and allow them to see the cervix (NSW Government n.d.).

A small brush will be used to take a sample of cells from the cervix. This procedure is often described as uncomfortable, but it should not cause pain (Queensland Health 2018; Department of Health n.d.).

This sample is put into a sterile tube and is sent to a laboratory to be examined. A doctor will then discuss the results with the patient (which should take about two weeks), which may reveal:

  • The patient does not have an HPV infection: In this case, they will not need another cervical screening test for another five years and they will be sent a reminder to do so by the National Cervical Screening Program.
  • The patient does have an HPV infection: It is likely their body will get rid of the HPV on its own. They will need another cervical screening test in 12 months time. It takes approximately 10 to 15 years for cervical cancer to develop. If the second test is clear, they won’t need another test for five years. If they still have the HPV infection after 12 months, they may be instructed to see a specialist.
  • The patient has a certain type of HPV or an abnormality was found: A doctor will refer them to a specialist for further tests, this doesn’t necessarily mean cancer is present.
  • The test result was unsatisfactory: Their sample could not be read at the laboratory. It will be necessary to repeat the test in 6 to 12 weeks.

(Healthdirect 2018)

While the procedure is uncomfortable and not something that people generally look forward to, those few moments of discomfort could be life-saving.

cervical screening test
People who are eligible for the cervical screening test are those who: have a cervix; are 25 to 74 years of age; and have been or are currently sexually active.

Additional Resources

Multiple Choice Questions

Q1. True or false: HPV is responsible for 99% of all cases of cervical cancer.

  1. True
  2. False

Q2. Which of the following are criteria for having a cervical screening test?

  1. Having a cervix.
  2. Being 25 to 74 years old.
  3. Having been or are currently sexually active.
  4. All of the above.

Q3. True or false: 18 is the age that a person should first undergo a cervical screening test?

  1. True
  2. False
References

(Answers: a, b, d)

Author

Portrait of Ausmed Editorial Team
Ausmed Editorial Team

Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile

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Learner Reviews

4.5

90 Total Rating(s)

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Nicole stephens
01 Apr 2020

Reinforced existing knowledge in order to be confident when discussing cervical screening with women

Portrait of Rose Lewis
Rose Lewis
28 Mar 2020

Interesting and concise.

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Nicole Dillon
06 Mar 2020

a brief but efficient explanation of the cervical screening test.

Portrait of Charlotte Gunson
Charlotte Gunson
21 Feb 2020

Very concise and informative. A couple of small errors (Cervical screen does not protect against HPV; Answers for mini-quiz).

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Jessica Blackmore
18 Feb 2020

Very useful

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Laura McPhee
10 Feb 2020

This article was very informative, easy to read and had good, up-to-date references.

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Francina Barbara Moule
31 Jan 2020

This is a succinct update on cervical screening

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Ursula Wulff
29 Jan 2020

Should include that midwives can also provide cervical screening.

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Kerryn cottier
27 Jan 2020

Informative reading

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Evelyn Boyce
20 Jan 2020

Gave a good overview of the change in policy and new screening intervals