Cervical Screening Test – What Does an Abnormality Mean?
The pap smear has now been replaced by the new cervical screening test (CST). This is a simple test that checks the health of your cervix and screens for pre-cancerous and cancerous changes to your cervix and looks for the presence of the HPV virus.
What does an abnormality mean?
The pap test used to look for cell changes in the cervix but the new CST looks for human papilloma virus (HPV). If the HPV virus is detected then the result is considered abnormal. The sample is then sent for further testing for the presence of abnormal cervical cells. This result may show normal, low grade or high grade dysplasia (pre-cancerous changes). Depending on the abnormality you may require a colposcopy where the cervix is looked at with a microscope, the area is stained with vinegar so that abnormal tissue can be easily visualised. If a significantly abnormal area is located then a biopsy may be taken.
Is HPV common?
HPV is an extremely common virus in men and women and is acquired by genital skin-to-skin contact during sexual activity. Four out of five people will have been infected with the HPV virus at some point in their lives but not be aware they have it, as there are usually no symptoms. In most cases (98%) HPV clears without treatment but in a small number of patients the virus persists. There are 14 types of HPV that the CST can detect.
The test most commonly identifies HPV types 16 and 18 that cause approximately 70% of all cervical cancers. Your body’s immune system will naturally clear most types of HPV within a year or two. If your body does not clear the HPV infection it can cause cells in your cervix to change and cervical cancer may develop following persistent infection with the HPV virus. It is important to understand that it takes somewhere between 10 and 20 years for a cancer to develop.
If you have HPV sub-type 16 or 18 you will be advised to have a colposcopy performed. If you have a sub-type that is not 16 or 18 (non-16/18) and it is detected for the first time, a repeat cervical screening test in 12 months is recommended. However, if the sub-type is non-16/18 and you have high-grade cell changes a colposcopy will again be necessary. If after 12 months the non 16/18 HPV virus is still present on your CST, a colposcopy will be required.
Cervical cancer is avoided, once you are found to carry the HPV infection, with regular cervical screening. By detecting the presence of HPV Dr Kliman can monitor the infection and intervene if there are changes to the cells in your cervix that are significant.
Is there a treatment for HPV?
There is no treatment for HPV and in most cases the immune system will clear the HPV virus from the body naturally, however, if you are found to carry HPV then close surveillance and monitoring is required depending on which HPV sub-type you carry, will depend on what treatment is recommended. Dr Kliman and the laboratory performing the testing will make a recommendation about your follow-up.