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What causes cervical cancer?

Long term infection with certain types of a virus is now known to be the cause of almost all cervical cancers.

Key facts:

• HPV is a virus (the human papilloma virus).
• Almost all abnormal Pap smear results are caused by HPV.
• Anyone who has ever had sex can have HPV - it’s so common that four out of five people will have had HPV at some time in their lives.
• In most cases, it clears up by itself in one to two years.
• In rare cases, if the virus persists and is left undetected, it can lead to cervical cancer. This usually takes about 10 years.
• A Pap smear every two years can detect any abnormal cell changes caused by HPV, which can then be monitored and/or treated to prevent cancer.

A Pap smear every two years can detect the presence of HPV, which can then be monitored and/or treated to prevent cancer. While HPV is very common, most women with HPV will not develop cervical cancer.

Who is at risk of cervical cancer?

All women with a cervix who have ever had sex are at risk of cervical cancer. About half of the new cases of cervical cancer diagnosed each year are in women over 50 years of age. Women over the age of 50 years are less likely to have regular Pap smears. More of these women die from cervical cancer because their cancer is diagnosed at a later stage, when treatment is less effective. Having a regular Pap smear every two years will help prevent most of these cancers in older women.

Often women feel they do not have time to have a Pap smear, but it is so easy to overlook your own health. A Pap smear only takes a few minutes and is the best protection against cervical cancer.

What are the symptoms of cervical cancer?

In the early stages of cervical cancer, there are usually no symptoms at all. The only way you will know is if you have a Pap smear.

Do I still need a Pap smear if I don’t have symptoms?

A Pap smear is for women who don’t have any symptoms. It helps detect changes before they develop into cancer. As with most cancers, the risk of cervical cancer increases with age. All women should have regular Pap smears between the ages of 18 and 70.

Am I too old to need a Pap smear?

As with most cancers, the risk of cervical cancer increases with age. All women should have regular Pap smears between the ages of 18 and 70.

What is a Pap smear?

A Pap smear is a quick and simple test in which a number of cells are collected from your cervix and sent to a laboratory where they are tested for changes. No drugs or anaesthetics are required and a doctor or women’s health nurse can easily do it. It only takes a few minutes and is the best protection against cervical cancer.

What does it feel like?

Sometimes having a Pap smear can be a little embarrassing. Remember, for the person taking your smear, this is just part of their everyday work. If the Pap smear feels uncomfortable or hurts, tell your doctor, nurse or health worker straight away.

How effective are Pap smears?

A Pap smear every two years can prevent the most common form of cervical cancer in up to 90% of cases and is your best protection against cervical cancer.

What if I’ve only ever had one partner?

You’re still at risk. Pap smears can prevent up to 90% of cervical cancer.

When should I start having Pap smears?

All women who have ever been sexually active should start having Pap smears between the ages of 18 and 20 years, or one to two years after first having sexual intercourse - whichever is later.

Does an abnormal result mean that I have cancer?

No! Over 90% of Pap smears are normal. Only a small number show changes in the cells of the cervix. Most of these changes are due to HPV infections which usually clear up naturally without any need for treatment. In a small number of women, these changes may develop into a high grade abnormality and in an even smaller number, may progress to cervical cancer. When detected early by a Pap smear, these changes can be treated and cured. That is why having a Pap smear every two years is so important.

I’ve been through menopause. Do I still need to have Pap smears?

Yes. The risk of getting cervical cancer increases with age. If you have ever had sex, even with only one partner, it is important to keep having Pap smears. A Pap smear every two years until you are 70 years old, even after menopause, is your best protection against cervical cancer.

I’ve had a hysterectomy (womb taken out). Do I still need a Pap smear?

Usually, no. However, in some cases Pap smears may still be needed. If you have had a total hysterectomy, that is, your uterus and cervix removed, and have ever had treatment for severe changes on the cervix, it is recommended that you continue to have Pap smears taken from the upper vagina. If your hysterectomy was only partial, and your cervix was not removed, you will still need to have a Pap smear every two years. Check with your doctor to be absolutely sure.

How much does a Pap smear cost?

Two costs are involved – the doctor’s consultation fee and the Pap smear pathology test. Some doctors, clinics and health centres ‘bulk bill’ and if so, there are no out of pocket expenses for women.

If a fee is charged, the cost to you will be the difference between the Medicare rebate and the doctor’s and laboratory fees. In some cases you may be required to pay the full cost for the consultation and laboratory fee and then claim the rebate from Medicare. Ask what the cost will be when you make an appointment. Ask the doctor, nurse or health worker who did your last Pap smear. So you won’t forget, your doctor or health centre can place you on a confidential reminder system. If you are overdue you will be sent a reminder from your local Pap test register.

What if I don’t remember when I had my last Pap smear?

Your doctor or health clinic may have a system to remind you when it’s time for your next Pap smear. You will also be sent a reminder from your local Pap test register when your Pap smear is overdue.

All Australian states and territories have registers, which keep a confidential record of your Pap smear results and provide a valuable, confidential backup system. The register provides an important safety net by sending you a letter if your Pap smear or follow-up treatment seems overdue. You can choose if you want to receive the reminder letters or not. If you do not want information recorded on the register you should tell your doctor.

Where can I go for a Pap smear?

As well as by a general practitioner, you can have your Pap smear taken by specially trained nurses, health workers, or at well women’s clinics, community health centres or family planning clinics.

What if I’d rather not know?

A Pap smear every two years offers the best chance of detecting changes before they become cancer.

What does it all mean for me?

Make regular screening part of your life – a Pap smear every two years is your best protection against cervical cancer.

You can look and feel perfectly healthy, and still have cell changes in your cervix. Having a Pap smear is the only way to be sure.

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