A change in the way women are screened for cervical cancer in Australia is detecting cancer-causing and life-threatening infections sooner, new research has found.
Since 2017, Australian women have been offered HPV screening in place of the previous pap smear tests as part of the National Cervical Screening Program. The new screening looks for the human papillomavirus (HPV), as well as abnormal changes to cells in the cervix, while the previous pap smear test looked only for changes in the cervix.
Now, new research published in the Medical Journal of Australia, has revealed that the change has resulted in earlier detection of potential cancer-causing infections. More than 8 per cent of women in the primary screening program tested positive for the cancer-causing HPV, while abnormal cells were detected in a third of women.
And, when compared to the previous pap smear test, the study showed more than three times as many women were referred for colposcopy – a procedure used to closely examine the cervix for signs of the disease.
The new screening program involves HPV testing every five years for women aged between 25 and 74 and replaces the previous biennial pap tests for those aged between 18 and 69.
The National Cervical Screening Program distinguishes between HPV specimens submitted for primary screening and those submitted for non-screening purposes. Women with non-screening tests (where the purpose of the test wasn’t to screen for HPV) are at higher risk of cervical cancer because they show signs or symptoms of cervical abnormality.
Researchers reviewed 195,606 specimens submitted for HPV testing between December 2017 and May 2018.
Oncogenic HPV – which is a type of HPV associated with cervical cancer – was detected in 8.1 per cent of screening tests and 20.9 per cent of non-screening tests. Abnormal cells, or cytologic abnormality, was also detected in 35.5 per cent of women who underwent primary screening.
Repeat HPV testing after 12 months was recommended for 5.4 per cent of women, while a direct colposcopy was requested for 2.6 per cent of women screened.
It was also found that the rate of referral to colposcopy based on HPV primary screening was “considerably higher” than the historical primary cytology screening results.
“The higher rate is broadly consistent with clinical trial data and predictions from modelling,” the authors said. “The switch from cytology- to primary HPV-based screening in Australia will ensure cervical screening is evidence-based and best practice.”
The new procedure feels similar to the old test and is offered to all women until they reach the age of 74.
“Our findings indicate the renewed program is performing as expected during the initial HPV screening round,” researchers say.
HPV is the biggest risk factor for cervical cancer in Australia, with as many as 80 per cent of women becoming infected at some point in their lives. Still, not all women get cervical cancer as a result of the infection and only specific types – such as Oncogenic HPV which are tested as part of the screening – result in a cervical cancer diagnosis.
Any symptoms such as vaginal discharge, bleeding or pain should always be discussed with a health professional as soon as possible and between screening.
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