The main points
- The two-yearly Pap test has been replaced by the new five-yearly HPV cervical screening test (CST).
- The main cause of cervical cancer is long term infection with certain strains of the human papilloma virus (HPV).
- HPV testing is a much better test for determining future risk of developing cervical cancer.
- Cervical screening now starts at age 25.
- No matter how you identify, if you have a cervix it is recommended that you have a cervical screening test.
HPV and cervical cancer
The main cause of cervical cancer is long term (chronic) infection with the human papilloma virus (HPV).
HPV is spread through close skin-to-skin contact and is highly contagious. There are many different strains of HPV and not all increase the chance of developing cervical cancer. Those associated with an increased risk of cervical cancer are called oncogenic (cancer causing) HPV.
It is estimated that around 80-90% of those who are sexually active will be infected with at least one strain of HPV during their life. Most HPV infections do not cause symptoms and nearly everybody infected with one or more of the oncogenic (cancer causing) HPV strains will clear the virus without treatment. On average this takes anywhere between 1 – 3 years to clear.
In a small percentage of those infected, the virus will not be cleared by the immune system. This can result in long term infection which increases the risk of damage to the cervix. This damage, if left untreated may become cancerous over many years. It is this damage that was previously detected by the previous Pap test.
Cervical Screening for HPV instead of Papsmears
The Australian National Cervical Screening Program has recently changed and now recommends that anyone between the ages of 25-74 years, who has ever been sexually active, have a screening test for HPV. This allows the virus to be detected long before it causes damage to the cervical cells.
If you test negative for oncogenic HPV infection then you can safely rescreen in five years. If you test positive, your health care professional will advise the best option for you.
How is the new cervical screening test collected?
The new cervical screening test is collected in the same way as the previous Pap smear test:
- A speculum is used to open the vagina, enabling the cervix to be seen clearly.
- A soft brush is used to take a small sample of cells, which are then sent to the laboratory for HPV testing.
- If the sample is positive for HPV then the cervical cells are looked at in much more detail. Your cervical screening provider will be informed of the results and will talk to you about next steps.
- Some people who are unable to have or cannot tolerate a speculum examination may be eligible to take a vaginal swab instead. You will need to discuss this with your health care professional.
However as of 1 July 2022 everyone due for a cervical screen will be eligible for a self-collection Cervical Screen Test option. Find out more about the self-collection Cervical Screen Test option here.
What age do I need to start routine cervical screening?
In Australia, cervical screening starts at age 25.
Cervical cancer is extremely rare under the age of 30 and having cervical screening tests under the age of 25 has shown little or no improvement in the detection or survival rates of cervical cancer.
Treatment of abnormal Pap smear results in young individuals (under 25) has been demonstrated to increase the risk of specific pregnancy related complications. The recommendation to start screening at age 25 takes into consideration both the risks and benefits of screening.
Most adolescents are now vaccinated against the highest risk strains of HPV strains. This vaccine provides immunity not only to the individual also offers protection to the wider community.
The HPV vaccine does not cover all oncogenic (cancer causing) strains of HPV so even if you are vaccinated you still need cervical screening tests.
- Read more information about the HPV vaccine in Australia.
How often do I need a cervical screening?
All people who have ever been sexually active and have a cervix require five-yearly cervical screening. This applies even if you:
- have had the cervical cancer vaccine
- have only had one sexual encounter
- have only had one sexual partner
- haven’t been sexually active for many years
- are in a same sex relationship
- have gone through menopause.
What age does routine cervical screening stop?
Most individuals will continue routine cervical screening up until between 70 - 74 years of age. Those who test positive many need screening past this age.