Screening for cervical cancer is offered to all women in Australia. The screening programme has resulted in a reduction in the number of women developing and dying from cervical cancer. Cervical cancer is treatable if caught in the early stages. We now know that the majority of cases of cervical cancer is caused by the HPV (human papillomavirus) which is controlled by the routine vaccination of young women and men when they start high school. There are about 50 strains of HPV that can affect the genital area and vaccination covers the strains which are most likely to do harm.
Routine screening involves sampling cells on the surface of the cervix every 5 years to check if harmful strains of HPV virus are present. If they are detected, then the laboratories take a closer look at the cells to see if they have been damaged by the virus.
If there is evidence of the more aggressive strains of HPV (16 or 18) or there are signs that the cervical cells have been affected by the virus, then these women are referred for a closer look at the cervix. This is called a colposcopy.
A colposcopy is the medical name for a more detailed look at the cervix than would happen with a routine screen (pap) test. It means a speculum is in place for about 5 mins while the cervix is examined with a strong light and a microscope. The cervix is stained ,with very dilute acetic acid (vinegar) and then iodine, to help locate the area that is affected. If there is an abnormal area, then it is likely that a biopsy will be taken so that the laboratory can make a subjective and clear statement as to the extent of the abnormal cells. Most of the time the cell abnormalities are mild and treatment is not required. Most women will clear the virus naturally within 2-3 years. In these situations the screening test is simply repeated at yearly intervals until the virus has cleared. If the cell abnormalities are more severe then treatment may be the best option to prevent the disease from progressing to cancer in the future. Treatment usually involves laser treatment to the surface of the cervix to remove the affected cells. This is undertaken by a gynaecologist either in a public hospital or in private rooms.
At East Sydney Doctors we can do routine screening and also colposcopy. If the screening test suggests there is harmful HPV and /or cells changes then a colposcopy will be recommended. Doing this in general practice, means that you are more likely to be able to get a timely appointment, with a shorter visit time than in a hospital outpatients. The cost in general practice is significantly less than with a specialist.