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How is cervical screening changing?
From 12 September 2023, Aotearoa New Zealand is adopting a simpler screening test which is a better first test for the prevention of cervical cancer. As a result, most people will now only need to screen every five years. The new test looks for the Human Papillomavirus (HPV), that causes more than 95% of cervical cancers.
What’s HPV got to do with cervical cancer?
Almost all cervical cancers are caused by HPV. The virus is very common and is spread by intimate skin-to-skin contact or any sexual activity.
Most adults (80%) will have HPV at some time in their lives. The body usually clears the virus itself but some types can persist and go on to cause cell changes that may in time turn into cancer.
How do I get the new test?
The vaginal swab test is suitable for most people but, in some circumstances, you may need to have a cervical sample taken.
At this time, the test is available via engaging with a clinician. You will need to have an appointment with one of our doctors or nurses first to determine which test is best for you, and to gather the information that will aid with interpretation of the result.
How is it different to the test I’ve had in the past?
For most people HPV screening will replace the test (previously called a smear test) where a doctor or nurse took a cell sample from your cervix.
This new screening can be done as a simple vaginal swab. You can choose to do this as a self-test in a private place in a health clinic (such as behind a curtain or in a bathroom), or you can have your doctor or nurse assist you.
You can also choose to continue to have the test, previously called a smear test, where a cell sample is taken from your cervix.
For most people regular screening will now only be needed every five years (or five-yearly of you are immune deficient).
Is it safe to have such a big gap between screenings?
The screening gap can be safely extended to 5 years because the HPV test is a better first screening test. It’s a more sensitive test designed to find the cause of most cervical cancer. Cervical cancer often takes 10 years or more to develop. This means people at risk can be identified before cell changes begin to happen, so it’s safe to wait longer between screening tests.
Does this mean I won’t need a smear test anymore?
The swab test option will suit most people but may not be ideal for everyone.
For clinical reasons, some people will still be recommended to have a clinician-taken cervical sample, or you may still choose this option if you prefer it.
You can chat with one of our doctors or nurses to get information and advice, and together determine what is best for you.
If you do a self-test or have a clinician-taken swab test and HPV is detected, you will either need to return for a cervical cell sample to be taken or be referred to a specialist clinic. This will depend on the type of HPV found. Around 10% of participants will have an HPV Detected result.
How soon will I get my results?
Your HPV result will usually come back within two weeks. We will always make contact with you if you if you have an abnormal result that requires actioning, and we would encourage you to join our Manage My Health portal so that you can also view your results.
What can I expect from my results?
Most test results are normal. Around 90% of people screened will be found not to have HPV.
If HPV isn’t found, your risk of developing cell changes that may lead to cancer is very low. This means you won’t need to be screened for another five years (three years if you are immune deficient).
What if HPV is found in my sample?
It doesn’t mean you have cervical cancer. Most HPV infections clear up by themselves. However, if the virus is found, you will be referred for further checks to see if there are any cell changes on your cervix. It may be recommended that you have a test to check the cells of your cervix (previously called a smear test) or a colposcopy (kol-poss-kapee). Both tests look for cell changes that, if untreated, may develop over time into cervical cancer.
How accurate is HPV cervical screening?
The HPV test is very sensitive at finding HPV, whether you opt for the self-test, get your health provider to help, or have an examination of your cervix.
However, no test is perfect and there’s a very small chance that HPV or cell changes could be missed. That’s why it’s important to have regular screening and, if you have any symptoms in between screening appointments, to report them to your doctor.
What symptoms I should I be concerned about?Bleeding or spotting between periods or after your periods have stopped (after menopause)
These symptoms can happen for several reasons and rarely mean cervical cancer. However, they should be checked by a doctor.
How do I know if I’m eligible for cervical screening?
Cervical screening is available to wāhine/women and people with a cervix aged 25 to 69, who have ever had intimate skin-to-skin contact or any sexual activity, no matter their sexual orientation.
What if I’ve had a hysterectomy?
If you’ve had a total hysterectomy (removal of the uterus and cervix) check with your healthcare provider to see if you still need to have screening.
Is it okay to have a cervical screening test if I’m pregnant?
It is safe to have a screening test when you are pregnant, but it is best to discuss this with your healthcare provider.
Can I have a screening test when I have my period?
If you’ve got your period, you can still have a screening test, provided bleeding isn’t too heavy as this could affect the test result.
Will I have to pay to do a screening test?
The National Cervical Screening Programme is not a fully-funded screening programme. However, Te Whatu Ora has announced funding to provide free cervical screening services for key groups from 12 September 2023, as part of its move to the new HPV test.
Those who will be eligible for free cervical screening include wāhine/women and people with a cervix who are unscreened (have never had a screening test), under screened (haven’t had a test in the past 5 years), at higher risk requiring surveillance/follow up, Māori, Pacific, and anyone who is a Community Service Card holder. This includes those populations that are at a higher risk of cervical cancer.
There is also support available to assist you in attending screening appointments. More information can be found here.
How do I know if I’m signed-up for cervical screening?
You automatically become enrolled for cervical screening when you turn 25 and have your first cervical screening test. If you’re not sure if you’re on the National Screening Register, call 0800 729 729 and check. Being on the NCSP-Register means you will get an invitation to screen and reminders when your screening is due.
What if I don’t want to have cervical screening?
You can choose not to be part of the cervical screening programme or to withdraw any time. Contact the programme and we’ll send you a form to complete. All information about your cervical screening tests and history will be removed from our records.
You can still arrange screening outside of the National Screening Programme if you prefer, but any results won’t be recorded or tracked on the NCSP-Register. You can also re-join the Programme anytime if you change your mind.
How do I know if I am due or overdue for screening?
If you are registered with our patient portal you will see a recall advising when your next cervical screen is due. At any time you can also reach out to our nurse via phone, email or portal to enquire about this. You can also contact the NCSP-Register to find out if you are due or overdue for screening, to change your contact details, or to ask any other questions. You can contact the NCSP by free phoning 0800 729 729 or emailing email@example.com.
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