Dr Harrie Swanepoel
FRANZCOG, MMED (O&G)(Pret), FCOG (SA), MBChB (Pret)
Phone : 07 4331 1545
The NEW Cervical Screening Test & Abnormal PAP Smear results
& COLPOSCOPY
Why have a Cervical Screening test / Pap smear?
Cervical cancer is cancer of the cervix, which is the lower part of the uterus or womb.
Persistent HPV infection, usually with certain high-risk types of HPV, can cause abnormal cells to develop on the cervix.
Regular Cervical Screening Tests can detect HPV, which is a key risk factor in the development of cervical cancer.
Without regular Cervical Screening Tests, HPV may remain undetected and could develop into abnormal cells or cervical cancer, usually over many years.
What is a Cervical Screening Test (CST)?
The new Cervical Screening Test are performed in exactly the same way as the old pap smear and is a quick and simple test used to check the health of your cervix. The Pap Smear test every 2 years has been replaced with the new Cervical Screening Test every five years. The Cervical Screening Test looks for human papillomavirus (HPV) infection.
How do you know if your required to have the test?
All women aged 25 to 74 years who have ever been sexually active and have a cervix, should have a Cervical Screening Test every 5 years.
HPV!!!!! Human Papilommavirus. Please explain!!
Cervical cancer is almost exclusively caused by the HPV virus. It is only in recent years that we were able to make the connection between cervical cancer and the HPV virus.
There are many types of HPV and your body’s immune system will naturally clear most types within one to two years.
If your body does not clear a HPV infection, it can cause changes to cells in your cervix, which in rare cases can develop into cervical cancer. It usually takes 10 to 15 years for HPV to develop into cervical cancer.
How did I get a HPV infection
Human papillomavirus (HPV) is a common virus that is spread by genital skin-to-skin contact during sexual activity. It is so common that many people have it at some point in their lives and never know it as there are usually no symptoms.The virus is so common that it is a normal part of being sexually active. You can be exposed to HPV the first time you engage in sexual activity, and from only one sexual partner. A HPV infection does not necessarily mean that you or your partner has been unfaithful. HPV infection is very common and the HPV virus can remain inactive for long periods of time in the body. For most people, it is impossible to know when or from whom they were infected with HPV.
How is HPV treated ?
There is no treatment for HPV. In most cases the immune system will clear HPV from the body naturally over time. Most people with a HPV infection have no symptoms and will never know they have it.
If your body does not clear a HPV infection, it can cause changes to cells in your cervix, which in rare cases can develop into cervical cancer. If cervical cell changes are found as a result of your Cervical Screening Test, your healthcare provider will advise you about further testing and treatment.
Some types of HPV can cause genital warts and can be treated medically or surgically.
Do I need to avoid having sex if I have a HPV infection?
You do not need to stop having sex if your Cervical Screening Test shows you have a HPV infection.
The HPV virus is very common and there is no way of knowing if your partner currently has, or has previously had, this type of virus. Most of the time your body can clear the virus without causing any problems.
HPV Immunisation
A vaccine called Gardasil 9 has been developed which can significantly decrease your child's chances of developing HPV-related cancers and genital warts. See link below .
Where can I get more detailed and reliable information on the new Cervical Screening Programme?
-
Cancer Screening website -----cervicalscreening.org.au
-
National Cervical Screening Program 13 15 56
www.cervicalscreen.health.gov.au -
HPV vaccine
www.hpvvaccine.org.au
OR browse through these easy to listen YOU TUBE presentations.
Abnormal PAP Smear results
WHAT NOW?
Firstly – DON’T PANIC!
An abnormal pap smear does not mean you have cancer.
Your results show you have:
-
A type of HPV infection that requires further investigation, or,
-
Abnormal cells were found that require treatment
THE NEXT STEP IS TO HAVE A COLPOSCOPY
What is Colposcopy?
Colposcopy is a simple procedure performed at the time of your visit if required and is designed to give you immediate answers to your concerns. It involves a similar process to taking a pap smear with the additional use of a high-definition magnifying device known as the Colposcope, which enables a very clear magnified view of the cervix.
A dilute solution of acetic acid (vinegar) is sprayed onto the cervix during this examination to help clarify the abnormal cells better. A small biopsy may be required at this time with a specialised device, which takes a split second to perform usually with minimal discomfort. Results are then reviewed usually within 24-48 hours and discussed either in person or over the phone.
What if I need treatment?
Should treatment be required this is most often done as a day surgical procedure either under local or general anaesthetic. This is known as a LLETZ procedure. A larger treatment specimen called a CONE biopsy may sometimes be necessary also as a day surgical procedure depending on size and position and severity of the lesion being treated.
Is treatment effective?
Treatment for premalignant conditions of the cervix is usually extremely effective in curing the condition as a once off procedure and rarely interferes with future fertility and delivery. This will be discussed in detail if you require treatment.
What follow up do I need?
This will be discussed with you on the basis of your individual circumstances but generally current recommendations after successful treatment require a cervical screening and co-test after 12 months at a service provider of your choice. If this is all OK further smears are not required for another 12 months. Generally speaking if you have 2 negative smears one year apart you will be deemed cured and will be asked to have your next cervical screening test in 5 years time. A follow up plan will be clearly outlined and documented for you. Some conditions such as Adenocarcinoma-in-situ ACIS require ongoing regular colposcopic surveillance for follow up.