It is important to remember that almost all abnormal Cervical Screening Test (CST) results are not due to cancer.
The CST is a screening tool used to detect potential abnormalities in the cervix. The cervix is the lower part of the uterus at the top of the vagina.
An abnormal CST result means that the Human Papilloma Virus (HPV) is present in the cervical cells. The HPV virus is very common and can lead to abnormalities in the cervix.
A positive result will require further investigation (colposcopy – please see below) or ongoing monitoring with a CST.
HPV negative (low risk) – You will need to have a repeat CST in 5 years.
HPV positive 16/18 or HPV positive non 16/18
Human papilloma virus is a very common virus and anyone who has ever had sex can have HPV. Four out of 5 people will have had HPV at some time in their lives.
There are more than 100 types of the virus. About 40 types of HPV can cause abnormal Pap Smears. HPV types may be “high-risk” types (16/18) or “low-risk” types (non 16/18).
Most types of HPV are harmless, do not cause any symptoms, and go away on their own in one to two years. If you smoke, it is more likely that HPV will persist – so quitting smoking will help your immune system to clear the virus.
If left untreated HPV may cause changes in the cervix that may lead to cancer. This can take many years. This is why you need to have a HPV test every 5 years.
If you are HPV positive the laboratory will automatically perform a microscopic inspection of cells that were sent to them with the HPV test (Pap test). This will help guide management.
If you are positive for HPV 16/ 18, you will be referred to a Gynaecologist for a colposcopy. A colposcopy is a microscopic inspection of the cervix looking for abnormalities. Most people will not have any serious abnormalities but it is very important that you attend all your appointments.
If you are positive for HPV non 16/18 and the Pap test is abnormal you will be referred for a colposcopy. This does not mean there is an abnormality but that there are sufficient changes to warrant further investigations.
If you are positive for the HPV non 16/18 and the Pap test is normal then you will be asked to return for another HPV test in 12 months.
Now that we are testing for HPV you only need to be screened from 25 years of age. Women are tested up to the age of 75.
Women who commence intercourse prior to the age of 14 and who did not receive the vaccine can be tested from 20 years of age.