Pap smear tests
Pap smear tests are currently used in Australia as a screening test for cervical cancer. A Pap smear test can detect changes in the cells of the cervix that may develop into cancer. These changes are almost always caused by persistent infection (often for 10 years or more) with certain types of the human papillomavirus (HPV). By finding these changes early, they can be treated before becoming cervical cancer.
Pap tests get their name from Dr George Papanicolaou, who in the 1940s developed the test. This procedure became known as the Pap smear, or Pap test.
Who should have a Pap smear test?
The current Cervical Screening Program in Australia recommends that women should have an initial Pap smear test at age 18 or within 2 years of becoming sexually active (whichever is later).
You need to keep having Pap smear tests every 2 years, even if you are no longer having sex. You should continue having these tests through menopause, until the age of 70 when your doctor may advise that continued testing is no longer required.
If you have had a total hysterectomy, routine Pap tests may no longer be necessary, but it is important that you check with your doctor before discontinuing them.
Also, women of any age who experience symptoms such as bleeding or pain should see their doctor, who may recommend testing.
Do I still need to have a Pap smear if I’ve had the HPV vaccine?
Even if you have had the HPV vaccine (Gardasil or Cervarix), you should still have Pap smear tests. This is because the vaccine doesn’t protect against all types of HPV that can cause cervical cancer.
Where do I go for a Pap smear?
Pap smears are available through your GP, family planning clinic, sexual health clinic or local community health centre, and the test is generally covered under Medicare. However, costs may vary, so check when making an appointment.
How are Pap smears done?
Pap smears can be done in a few minutes and involve collecting a sample of cells from the surface of your cervix.
To collect the cervical cells, your doctor or specialist nurse will insert an instrument called a speculum into your vagina to hold it open so that they can see your cervix. Special small instruments (such as a spatula and soft brush) are used to gently take a small sample of cervical cells. You may feel uncomfortable for a few moments during the test, but it should cause no pain and no anaesthetic is required.
The collected sample of cells is smeared onto a glass slide. Some cells from the sample may also be put into a special liquid in a small container for a test called liquid-based cytology (e.g. ThinPrep Pap test). The samples are then sent to a laboratory to be tested and viewed under a microscope. You should have the results within a week.
What if I get an abnormal Pap test result?
If your Pap test does have an abnormal result, try not to worry. There are many reasons why this might happen and most are not serious, so ask for an explanation and discuss any concerns you may have with your doctor.
If abnormal cells are noted in the Pap smear, your doctor may recommend a repeat Pap test in 6-12 months, or you may be referred to a gynaecologist (specialist in conditions affecting the female reproductive tract) or gynaecological oncologist (gynaecologist that specialises in cancerous and precancerous conditions) for further testing and treatment.
Women who have had an abnormal Pap smear result may need to have more frequent screening tests in the future.
Changes to cervical cancer screening in Australia
In late 2017, the Australian recommendations for cervical cancer screening will change. The new programme will involve having a human papillomavirus (HPV) test every 5 years, from age 25 (or 2 years after first having sex - whichever is later) to age 74.
The new National Cervical Screening Program will improve detection of early cervical cancer and be equally as safe as the current programme.
Pap smear registers are currently in operation in each state and territory. A national register will operate when the new National Cervical Screening Program starts in late 2017. Eligible women will be invited via the register to have a cervical screening test when they are due for testing. Women should continue to have Pap smears every 2 years as usual until the new programme is implemented.
2. Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activities in general practice, 9th edition. 9.5 Cervical cancer. http://www.racgp.org.au/your-practice/guidelines/redbook/9-early-detection-of-cancers/95-cervical-cancer/ (accessed Jun 2017).
3. Cancer Council Australia. Understanding your Pap smear (updated 9 May 2017). http://www.cancer.org.au/about-cancer/early-detection/early-detection-factsheets/understanding-your-pap-smear-results.html (accessed Jun 2017).
4. Cancer Council Australia. Cervical cancer (updated Oct 2015). http://www.cancer.org.au/about-cancer/types-of-cancer/cervical-cancer.html (accessed Jul 2017).