WOMEN'S cervical screening is a confronting and for many seniors an unpleasant experience, but a necessary medical exercise, at least until the age of 74.
Up until December last year Australian women aged 25 and upwards were encouraged to have a Pap test every two years by their GP. A new testing regime is now in place, called a Cervical Screening Test which collects cells in a similar way to the Pap test. But this test is looking for human papillomavirus which can lead to cell changes in the cervix, while the Pap test was used to look for existing changes in cells.
When a CST is normal, testing will be done every five years by a GP. This timeframe is based on that being the minimum time cervical cancer can develop.
Gynaecologist Dr Bogdan Benga explained that the change in the testing regime is in response to false negatives in some Pap test results and some missed lesions.
"The main driver for us to change the screening is because nearly all cervical cancers are due to an infection from a high-risk papilloma virus," Dr Benga said. "The new test can pick up the high-risk viruses that are linked with cancer. It revolutionises the way we look at screening for cervical cancer."
The Pap test still exists, but will only be used to obtain further information on abnormal cells where an HPV screening test returns a positive. The specimen collected in one examination will be used for both tests.
Dr Benga expects the viral test combined with the Pap test will become the "mainstay" in cervical screening.
- The new screening test is particular to asymptomatic women such as a woman who is post-menopausal and hasn't had any more bleeding.
- If a woman experiences abnormal symptoms like bleeding with intercourse or in between periods she then needs to be assessed by a specialist even if her cervical screening test was negative.
- "Women aged 70 to 74 with negative viral test are eligible to safely exit cervical screening," Dr Benga said. However, if they get a positive during their last tests they will need to see a specialist for further assessment.
- The risk increases with changing sexual partner as this exposes the woman to new high-risk viruses that she has no immunity for.
Dealing with discomfort
For women who have gone through menopause and then find the use of speculum, which opens up the vagina, a painful experience, they should talk to their GP about using topical oestrogen cream, such as Ovestin, before being tested.
"This treatment needs to be done for a short period of time prior to the examination and is very safe even in women with prior history of breast cancer," Dr Benga said.
In the future
"We are still in the process of testing to see how easy it is for patients to self-collect their screening test," Dr Benga added.