Papanicolou or cervical smear
Cervical cells are collected by brush or spatula for microscopic examination. This is a widely used screen for precancerous changes in cervical cells. In Australia, regular two yearly tests are recommended for all women aged 20 to 69 years or if under 20 years, 1 to 2 years after first intercourse. More frequent testing may be required if abnormalities are detected. Most of the costs may be claimed from Medicare. Screening may cease for women aged 70 years and over if they have never had a significant cervical abnormality and they have had two negative tests in the last five years.
All States and Territories have Cervical (Pap) smear result Registers that help doctors recall women for testing and keep track of any follow-up investigations. It is therefore important that all women ensure their GP has their correct name and address details and inform them of these changes. For information visit the National Cervical Screening Program. Women who have not had a regular smear test may be offered one when they attend their GP on another matter.
The role of HPV testing is currently limited as the great majority of infections do not result in cervical cancer. A Medicare rebate for HPV testing is only available during the follow-up of women with a previously-treated high-grade abnormality.
- Colposcopy - a follow-up test that may be advised if abnormal cells are found on a smear or if frequent inadequate smears are obtained. Colposcopy is a simple examination that involves putting a vinegar-like solution on the cervix and then using a magnifying instrument to look closely at the cervix, checking for abnormal areas.
- Biopsy – if, at colposcopy, abnormal looking areas are found on the cervix, small pieces of tissue will be removed for examination by a pathologist. A biopsy and microscopic evaluation is the only way to tell for sure whether abnormal cells are cancerous, precancerous, or reactive for some other reason.