Pap smears and HPV

How effective is the Pap smear?

Regular Pap smears every two years can help prevent up to 90 per cent of the most common type of cervical cancer. It is still the most important step in preventing cervical cancer. It is a quick process and you can have confidence in our experienced GPs.

At the time of having your pap smear you may also have an STI check and a breast check. Ask your doctor here during your consult.

How often should I have a Pap smear?

All women over 18 who have ever had sex are advised to have a Pap smear every one to two years, even if they no longer have sex.

Your general practitioner may recommend more frequent Pap smears if a previous smear showed significant cell changes or you experience problems, such as bleeding or pain after sex.

What are the symptoms of cervical cancer?

In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap smear.

If you have any abnormal vaginal bleeding (such as intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your general practitioner without delay.

Pap Smear Results

We will usually receive your Pap smear result within two weeks. We ask that you ring for a result message and speak with our nurse or practice assistant for the doctor’s written result for you.

If followup is needed we will ask you to consult with the doctor for explanation and treatment options.

We also use a recall system for reminders and followup to give maximal health treatment.

Abnormal Pap Smear Results

Many women feel anxious or worried when they have been told that their Pap smear result is not completely normal. An abnormal result hardly ever means you have cancer.

About one in every 10 Pap smear results will have a comment or indicate some kind of problem. Most of these are not serious, and your general practitioner can discuss this with you.

Unsatisfactory sample

Sometimes the report will indicate that the sample was unsatisfactory. This may happen for a variety of reasons and is commonly because:

  • the cells may be obscured by blood, inflammation or mucous;
  • there may not be enough cells on the sample to give an accurate assessment.

If any of these problems occur, you will be asked to have another Pap smear in 6-12 weeks. This allows time for the cells of the cervix to renew, so there are enough for another sample.

Inflammation

Quite often a Pap smear will show signs of inflammation.
This means that the cells of the cervix are slightly irritated.

This irritation may be due to an infection, even though you may not be aware of any symptoms. This might be a bacterial infection or thrush.

Sometimes the cause of the infection can be detected by the Pap smear. Your doctor or nurse will talk with you about further tests to identify the infection and what treatment is required.

Sometimes there is no cause found for the inflammation and the cell changes will go back to normal without the need for any treatment.

HPV (human papillomavirus)

HPV is a very common virus, with four out of five people having it at some stage of their lives. In some cases, it can increase a woman’s risk of cervical cancer. However, most women with HPV do not develop cervical cancer.

About HPV

There are over 100 different types of HPV, including some that affect the genitals. Genital HPV is similar to the virus which causes warts on other parts of the body.

Genital HPV is so common that it could be considered a normal part of being a sexually active person. Most people will have HPV at some time in their lives and never know it.

You may become aware of HPV if you have an abnormal Pap smear result, or if genital warts appear.
HPV infection is very common and in most people it clears up naturally in about 8-14 months.

What does HPV have to do with cervical cancer?

A few of the many types of HPV have been linked with causing abnormalities of the cervix and in some cases the development of cancer of the cervix.

It is important to remember that most women who have HPV clear the virus naturally and do not go on to develop cervical cancer.

In a small number of women, the HPV stays in the cells of the cervix.

When the infection is not cleared, there is an increased risk of developing abnormalities. In very rare cases, these abnormalities of the cervix can progress to cancer.

When cervical cancer develops, HPV is found in almost all cases.

Having regular Pap smears is the best way to ensure that any changes are monitored and managed to protect your health.

If you have early cell changes due to HPV, there is a strong likelihood that these changes will clear up naturally in 8 to 14 months. Because of this, and the fact that cancer of the cervix takes around 10 years to develop, your doctor may recommend simply having another Pap smear in 6 to 12 months time.

How did I get HPV?

Genital HPV is spread through genital skin contact during sexual activity. As viruses are microscopic, HPV can pass through tiny breaks in the skin. HPV is not spread in blood or other body fluids.

While condoms are an important barrier to many sexually transmitted infections, they offer limited protection against HPV as they do not cover all of the genital skin.

Because the virus can be hidden in a person’s cells for months or years, having a diagnosis of HPV does not necessarily mean that you or your partner has been unfaithful. For most people it is probably impossible to determine when and from whom HPV was contracted.

Can HPV be cured or treated?

There is no cure or treatment for HPV. It will, in most cases, be cleared up by your immune system. However, the effects of the virus, such as any warts that appear, or changes to the cells of the cervix, can be treated.

Consult your doctor or health practitioner if you are concerned about genital warts because of their appearance, or if they are causing you discomfort. There are a range of treatment options for warts.

If your Pap smear indicates that cells have been affected by HPV, you should have more frequent Pap smears until these cells return to normal. If the changes continue, further tests and treatment may be needed.

Should I have a special test for HPV?

There is an HPV test available which can test for the presence of a number of strains of HPV. This is NOT a test for cancer. HPV tests are available in Australia but are only subsidised by the government in a limited number of cases.

Experts now recommend that HPV testing be used for women who have been treated for a high grade abnormality or could have risk factors. The HPV test is done to make sure the virus has gone from your body.

An HPV test done for this reason will be subsidised through a Medicare rebate.

Your doctor can advise you if the test would be useful in your particular case.

While a Pap smear cannot identify which type of HPV is present, regular Pap smears will make sure any changes that occur are identified early and managed effectively.

What about a vaccine for HPV?

In April 2007, the Australian Government provided the human papillomavirus (HPV) vaccine Gardasil® to girls aged at least 12 but less than 14 years of age through the National HPV Vaccination Program on an ongoing basis.

Scheduled and funded under the Immunise Australia Program, from 2007 to 2009 there was a time-limited catch-up program, for girls aged 14 to 26 years of age delivered through schools, general practices and community immunisation services.

School-based program

The HPV vaccine is provided to 12-13 year old girls in the first year of secondary school. If you want your daughter to participate in the vaccination program, you will need to give your consent. Your daughter will bring a parental consent form home from school for you to sign. For more information about the School-based program, contact your daughter’s school or your State or Territory Health Department as they may vary in their delivery of the program.

As the HPV vaccine does not protect against all cancer–causing types of HPV women, whether vaccinated or not, should be screened for cervical cancer by having Pap smears every two years from 18 years of age or two years after the first time they have sexual intercourse, whichever is later.

HPV Vaccines at our clinic

For young women who may not have had the full course of HPV vaccines (e.g. 3 vaccines such as Gardasil), you can have this provided at our clinic.

Please enquire about having the HPV vaccine – by phone 9650 4218 or by email: manager@cpmc.com.au

For more information on the HPV vaccine, please visit the Immunise Australia Program website.

See also:
www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/papsmear

www.hpvvaccine.org.au/

www.nps.org.au/medicines/immune-system/vaccines-and-immunisation/for-individuals/vaccines-a-z/human-papillomavirus-hpv

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