Summary

  • The Pap test is a quick and simple test that checks for changes to the cells of the cervix that may lead to cervical cancer.
  • Abnormal cell changes in the cervix may not necessarily lead to cancer.
  • Treatment for cervical cancer includes surgery, radiotherapy, chemotherapy or a combination of these treatments.
  • The National Cervical Screening Program recommends that all women aged between 18 and 70 who have ever been sexually active should have a Pap test every two years, even if they’ve had the HPV vaccine.
The cervix (neck of the womb) is part of the female reproductive system. Cancer of the cervix (cervical cancer) is diagnosed in about 180 Victorian women each year. These cases are almost always linked to infection with the human papillomavirus (HPV).

Cervical cells pass through a series of changes (dysplasia) before they become cancerous and Pap tests are able to detect most of these changes. In Australia, regular Pap tests (also known as Pap smears) prevent about 1,200 women each year from being diagnosed with cervical cancer. Most women who develop cervical cancer have either never had a Pap test or did not have them regularly in the 10 years before diagnosis.

Even if you feel perfectly healthy, if you are a woman aged between 18 and 70 years (who has ever been sexually active), you should have a Pap test regularly every two years to check for changes in cervical cells. Currently, the Pap test is the best protection against cervical cancer for women who have been sexually active.

Function of the cervix

The cervix lies at the base of the uterus (womb) and opens into the vagina. Some of the functions of the cervix include:
  • producing lubrication for the vagina
  • producing mucous to help the movement of sperm
  • holding the baby in the uterus during pregnancy.

Symptoms of cervical cancer

Most cervical cell changes have no symptoms. The only way to know if there are abnormal cells in the cervix is to have a Pap test. Sometimes abnormal bleeding, discharge or pain may be a sign of cervical cancer. If you have these symptoms, you should see your doctor as soon as possible.

Types of cervical cancer

There are two main types of cervical cancer:
  • Squamous cell cancer – this is the most common type of cervical cancer. It starts in the cells that cover the outer surface of the cervix at the top of the vagina. The Pap test can usually detect early cell changes that could lead to squamous cell cancer.
  • Adenocarcinoma – this type of cervical cancer is less common. It starts in the glandular cells, which are found in the cervical canal. The Pap test cannot easily detect early changes that lead to this cancer, although sometimes these changes are picked up.

Risk factors for cervical cancer

Cervical cancer almost always develops from cell changes caused by the human papillomavirus (HPV), which is spread through genital skin-to-skin contact during sexual activity.

Other factors that can increase the risk of cervical cancer in women with HPV are smoking and low immunity (which can occur because of HIV infection or chemotherapy treatment). Daughters of women who took the anti-miscarriage drug diethylstilboestrol (DES) also seem to be at greater risk of cervical cancer. Women in this risk group should be seen annually in special gynaecology clinics.

Cervical cancer and HPV

Although HPV is common, most women with HPV will not develop cervical cancer. In most cases, HPV clears naturally from the body within one to two years, and doesn’t require treatment. Sometimes, the virus persists in the cervical cells and causes cell damage. If these changes are left undetected and untreated, the risk of developing cervical cancer increases.

Cervical cancer and the Pap test

The Pap test is a quick and simple test that checks for changes in the cervical cells that may lead to cervical cancer. Most abnormal cell changes are not cancerous, but indicate common infections or conditions, which usually clear up naturally.

Usually, cervical cancer grows slowly, but sometimes it can develop and spread quickly. Cervical cancer is one of the cancers that can occur in young women.

Diagnosis of cervical cancer

Various tests are used to detect cervical cancer including:
  • colposcopy – examines the vagina and cervix with a magnifying instrument to check for abnormalities
  • biopsy – a small tissue sample is taken from the cervix during a colposcopy
  • cone biopsy – a larger tissue sample is removed from the cervix under anaesthetic.

Treatment for cervical cancer

Some of the treatments for cervical cancer include:
  • cone biopsy – if detected early, some cervical cancers can be removed during a biopsy
  • hysterectomy – the removal of the uterus
  • radiotherapy – the use of x-rays to destroy the cancer cells
  • chemotherapy – the use of anti-cancer drugs that stop cancer cells from multiplying.

When a cure for cervical cancer isn't possible

If cervical cancer has been diagnosed in its later stages, the cancer may have spread to the point where a cure is no longer possible. Treatment then focuses on improving quality of life by relieving the symptoms. This is called palliative treatment.

HPV vaccine

There are two vaccines currently available in Australia to help prevent cervical cancer. Both vaccines work by preventing infection with two types of HPV, types 16 and 18. These two types have been shown to cause 70 per cent of cervical cancers. One of the vaccines, Gardasil®, also protects against HPV types 6 and 11, which cause almost all genital warts.

Since 2013, the HPV vaccination program in Australia has been extended to include boys, to help provide some protection from HPV-related cancers that affect men, such as penile and anal cancers. This means the Gardasil® vaccine is available free of charge for all girls and boys in year 7 of school, or those aged 12 to 13 years, as part of the school-based National HPV Vaccination Program.

Boys in year 9 of secondary school, or those aged 14 to 15 years, will also have the opportunity to receive the Gardasil® vaccine in 2013 and 2014 as part of a time-limited catch up program.

The vaccine provides best protection if it is completed before a person becomes sexually active. The three-dose course of Gardasil® vaccine should be completed. Dose two is given two months after dose one and dose three is given four months after dose two.

For all others, the vaccine is available at a cost. The benefit of the vaccine may be reduced for older men and women who have already had sex. Talk to your doctor about whether or not the vaccine will be beneficial for you.

The National Cervical Screening Program recommends that all women aged between 18 and 70 years who have ever been sexually active should have a Pap test every two years, even if they’ve had the HPV vaccine.

Where to get help

  • Your doctor
  • Gynaecologist
  • Local community health centre or women’s health nurse
  • Family Planning Victoria Tel. (03) 9257 0100 or 1800 013 952
  • PapScreen Victoria Tel. 13 11 20
  • Cancer Council Helpline Tel. 13 11 20
  • Multilingual Cancer Information Line, Victoria Tel. 13 14 50

Things to remember

  • The Pap test is a quick and simple test that checks for changes to the cells of the cervix that may lead to cervical cancer.
  • Abnormal cell changes in the cervix may not necessarily lead to cancer.
  • Treatment for cervical cancer includes surgery, radiotherapy, chemotherapy or a combination of these treatments.
  • The National Cervical Screening Program recommends that all women aged between 18 and 70 who have ever been sexually active should have a Pap test every two years, even if they’ve had the HPV vaccine.
References

More information

Cancer

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Content Partner

This page has been produced in consultation with and approved by: PapScreen Victoria - Cancer Council Victoria

Last updated: May 2014

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.