Australia introduced the Pap Smear Register not too long ago, where a female’s name was registered, and reminders were sent every two years to repeat the test. Originally, Mr Papinicolou was the first to perform what is now known as the Pap Smear on his wife, to document the changes that occurred. It became evident that this type of test could be used to identify women who may develop Cervical Cancer. Initially, the Pap Smear looked for cells that are changing and becoming abnormal.
Now, we have identified that abnormal cell changes are caused by the Human Papilloma Virus (HPV), which can be detected before cell changes occur. We now know that at various stages in a women’s life, they can carry the HPV wart virus (up to 80% of women test positive at some point in their life). Only a small percentage of these develop into abnormal cells, and an even smaller percent actually require treatment.
If you are a high risk carrier we will watch you carefully and perform smear tests more regularly than the routine 5 yearly tests. This may require regular Colposcopic assessments to look at the extent of the infection, however if we find abnormal cells they may or may not require treatment (only high grade cells require treatment).
Routine testing has now become the norm and involves scraping some cells from the surface of the cervix and checking them under a microscope. With the new Cervical Screening Test (CST) introduced in 2017, if your results are negative then you don’t need a repeat test for another five years. If your results are positive for one of the 13 types of wart virus’ that are known to cause cell changes, then you may be required to have yearly tests, or a Colposcopy.
Colposcopy’s involve spraying a vinegar solution onto the cervix, which makes the abnormal cells turn white. This allows us to identify the area of abnormal cells, and the percentage of the cervix that is abnormal. This abnormality is graded into three types of Cervical Intraepithelial Neoplaisa (CIN) each with a low- or high-grade change spectrum. Some results may require regular observation as there is moderate chance it will heal. With the new CST system, if they detect HPV you will also be referred to a Gynaecologist.
Treatment for abnormal cells either involves observing the cell changes or removing a minimal amount of the cervix through a LETZ Loop or Laser Diathermy procedure. Judith can perform the LETZ in her rooms under local anaesthetic. As always, the risks and benefits will be discussed in detail before the procedure.
If a Pap Smear hasn’t been done for many years, then there is a risk of cervical cancer being present. It will generally show with symptoms of abnormal bleeding, bleeding after sex or offensive discharge. If you experience ongoing bleeding, it is an indication to go and get a Pap Smear, rather than avoid it.
The testing should not hurt, and you shouldn’t be anxious. The aim is to find an affected area and observe or treat it before it becomes cancerous. Fortunately, pre-cancerous lesions are visible long before the cancer is active. These have no symptoms, so the only way to find them is with regular testing. The vigilance can also ensure your fertility is not put at risk.
If you would like to make an appointment to discuss any abnormal results with me at any of my consulting locations, except Epworth Geelong, you can find the details for phone, email or faxing through your referral on our Contact page.