If you’ve ever had an uncomfortable pap smear, or more recently an awkward cervical screening test, the thought has probably crossed your mind, “If only I could just do this myself!”
Well believe it not, you can DIY, with policy changing in 2022, giving Australian women the choice of whether to have their cervical screening test administered by their doctor, or collect the sample themselves. For women who have been anxious, reluctant or uncomfortable for cultural or personal reasons, it’s very good news. “We use it mainly for women who would otherwise not come in to see their doctor to get a cervical screening test,” Dr Michaela Sorensen, a GP specialising in women and family health explains. But you don’t need to have a religious or cultural reason to self-collect – it can be as simple as you preferring the discretion of collecting in privacy.
How does self-collection work?
Contrary to popular belief, self-collection is not a take-home situation. Instead, it generally takes place at a medical practice. “The doctor will give you the swab and you can do it privately behind the screening curtain or take it to the toilet,” Dr Suzette Pyke, a Sunshine Coast based GP, explains. “Your GP will give clear instructions on how to do it and there’s also an instruction sheet with written steps and pictures.”
Are there any circumstances where I can self-collect at home?
“If you live somewhere rural or remote and you’re having a telehealth appointment with your GP, this is something to ask about,” Dr Pyke says. “They may be able to post out the collection swab and instructions but there needs to be a plan for getting the sample to the pathology lab for testing.”
How do I self-collect?
The test comes a long cotton bud type swab in a protective tube which is very simple to use.1 “You twist the top off, pull out the long cotton bud and notice it has a red line on it,” Dr Pyke explains. “The red line is to indicate how far into the vagina you should insert the swab. Then you insert the swab into the vagina and gently rotate the swab two to three times for about 10 seconds.” Once removed from the vagina, the swab goes back into the tube with the lid replaced so the doctor can send it to the pathology lab for testing which can take a few days to a week.
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How accurate is self-collection for cervical screening tests?
The good news is, self-collection does not impact the accuracy of your results. “It’s the same rate of accuracy for determining whether someone’s got HPV or not, whether a doctor collects it or an individual self-collects,” says Dr Sorensen
Are they any women for whom self-collection is unsuitable?
Women presenting with abnormal bleeding after sex or between periods, or who experience pain during sex or pelvic pain are unlikely to be suitable for self-collection. “Women who come to see the doctor who have symptoms that we think could indicate that there might be an abnormality at the cervix will need a cervical screening test and an examination,” Dr Pyke says. “The only others who are not suitable are women who have had treatment recently for a [cervical cell] abnormality that has been detected. They undergo closer monitoring annually until they meet specific criteria and then can go back to the usual cervical test screening.”
Do I need to tell the GP in advance that I want a self-collected cervical screening test?
Some GPs appreciate you booking a long appointment for a cervical screening test but there’s no need to give them any particular notice about whether you’d prefer self-collection.
Can I still have the GP do the collection?
Absolutely, this is all about choice. “I’m finding that most of my most patients when I talk to them about self-collection as a choice, are actually choosing the clinician collected sample with an examination,” Dr Pyke says.
“When a doctor does a cervical screening test, we don’t just do the sample,” Dr Sorensen says. “We do a full examination of the area: looking at the external genital region, the vulva, the labia and internally at the cervix itself to see if there are any polyps, inflammation or anything else that could concern us too. But self-collected tests are really helpful for women that otherwise would not have been tested at all.”
References
1. Australian Government Department of Health and Aged Care. Self-collection for the Cervical Screening Test. [nd] Accessed September 3, 2023. https://www.health.gov.au/self-collection-for-the-cervical-screening-test
