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Cervical Screening Test (CST) from Home ~ Self Collection
It's now so much easier than the previous 2 year PAP smear to safeguard your well-being from cervical cancer - with a simple at home test every 5 years!
In Australia, you now have the option to collect your own sample for the Cervical Screening Test (much like the Covid PCR test).
This self-collected sample is examined for Human Papillomavirus (HPV), which is a prevalent STI responsible for nearly all cervical cancer cases.
At Clinic 66, we support Self-collection of a vaginal sample is just as effective at detecting HPV as a clinician-collected sample of the cervix.
Taking Preventive Measures into Your Own Hands:
Approximately 800 women in Australia receive a cervical cancer diagnosis annually, with around 70% of these instances affecting people who have not undergone screening or have fallen behind on their screenings.
If you are eligible, and would like to self-collect your sample, you can arrange a consultation with one of our telehealth General Practitioners. They will assess your eligibility, guide you through the simple process and send you a test request form.
No in person clinic visit required if you are eligible for self collection
Research confirms that a Cervical Screening Test using a self-collected vaginal sample delivers reliable results and comparable accuracy in HPV detection to a sample obtained by a clinician from the cervix during a speculum examination.
How to collect your own sample:
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Take your test request form to your local pathology collection centre to receive your swab. You’ll be provided with a private space to collect your sample or you can do it at home if you prefer.
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Twist the cap and remove the swab from the tube. Hold on to the cap and do not touch the end of the swab.
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Gently move the folds of skin around your vagina with your other hand. Insert the swab a few centimetres into your vagina. There may be a line on the swab stick that shows how far to insert the swab.
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Rotate the swab gently for 20 to 30 seconds.
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Gently remove the swab from your vagina. Push the swab completely back into the tube and give it back to the pathology collection centre, who will send your sample to a laboratory to be tested.
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IMPORTANT:
If you don't know when your last screening was, you can check at the National Screening Register
Website: www.ncsr.gov.au
Telephone: 1800 627 701
Hours of Operation: 8am to 6pm in all Australian state and territory time zones.
As a guide, when you call they may ask you personal information to help identify you, for example first name, date of birth and Medicare identification.
The National Cancer Screening Register (NCSR) is a world-first, digital platform developed to underpin the Australian Government’s National Bowel Cancer Screening Program (NBCSP) and National Cervical Screening Program (NCSP). The screening programs encourage age-eligible people to screen regularly so signs of cancer can be detected and treated early.
The NCSR has been designed to enable a single electronic record for each person participating in the programs, and provides a national electronic infrastructure for the collection, storage, analysis and reporting of screening program data.
What is a Cervical Screening Test (CST)? And what is a clinician collected test versus a self-collected test?
A Cervical Screening Test (CST) is a preventative check we recommend to screen for the Human Papilloma Virus (HPV) in the vagina, and to be able to look at cells from the cervix. With normal results, these tests are recommended every 5 years.
There are now two options for the collection of these tests.
Option 1: Clinician Collected CST
A clinician collected CST is just like the old-fashioned Pap Smear, where the clinician will insert a speculum into the vagina so that the cervix can be seen, and a sample is taken from the cervix. This sample is then sent to the lab where they can use PCR to look for HPV. If they find HPV present they can then do further tests on the cells of the cervix that were sent with this sample to look for any changes in those cells.
Option 2: Self Collected CST
You can now collect a sample yourself, using a specially designed swab which you insert into the lower vagina (easier than inserting a tampon). This sample is sent to the lab for testing.
If the lab finds Human Papilloma Virus (HPV) in your vaginal swab, you will need to get a clinician collected sample, so that the cells of the cervix can be checked.
Note: This option is for routine screening only (ie, if your last test was normal or if you've never had a test).
If you have a self-collected sample that finds HPV, or you are needing further screening after previous findings of HPV, then you require a clinician collected sample, so that the cells of the cervix can be checked.
Studies have shown that a self collected sample is just as good at finding HPV as a clinician collected sample. This is NOT collected from the cervix, so as long as you are able to insert a swab into your vagina and collect a sample (easier than a self-collected COVID test), then you can rest assured that this is a reliable, accurate, and safe test for you to do. They are even safe in pregnancy, and they can be collected in whatever setting you feel most comfortable (eg. at home).
While this may feel awkward, you can talk it through with a health professional, ask questions, be shown everything involved before consenting to any test or examination. If you have any fears or concerns, your health professional can help by talking these through with you.
All the Doctors at Clinic 66 online are happy to help if we can. All consultations are private and confidential, and we invite all of your questions.
Why do we need Cervical Screening Tests? And What is HPV?
Cervical Screening Tests (or CSTs) are recommended to reduce your risk of developing cervical cancer, or at worst, finding cervical cancer early.
The tests are looking for Human Papilloma Virus (HPV), and when that is found, it is important to check the cells of the cervix for any abnormalities.
Australia has a goal of no more cervical cancer by 2035. It is through routine screening that we can prevent cervical cancer. More that 70% of cervical cancers are found in people who have never been screened, or not done regular screening as recommended.
Having a genital infection with HPV (for example, of the cervix) is very common.
We catch HPV through sexually intimate contact, not just penis-in-vagina sex.
When we’re healthy our bodies are generally pretty good at clearing those infections, just like we clear other viral infections. It can take a few years to clear the Human Papilloma Virus though, and a small number of people have persisting infection (less than 1 in 10).
Those who have a persisting infection, especially if it is with type 16 or type 18 HPV, are those who we are concerned about developing abnormal cells, which can become cervical cancer. It is in the long stage before the cells become cancerous that we have an opportunity to find abnormalities, provide treatment, and therefore aim to prevent cancer.
Who needs Cervical Screening Tests?
Cervical screening is recommended for people who are:
Aged between 25 and 74 years old
Has a cervix (assigned female at birth)
Have ever had any type of intimate contact – direct genital skin-to-skin contact, penetrative sex, oral sex, intimate genital contact for example with foreplay, anal sex, and potentially a range of settings (eg fingers and toys) - This includes people who are lesbian, bisexual, transgender, queer, non-binary, etc
5 years since their last screening (the test can be done a minimum 57 months, that is 3 months short of the 5yrs)
This includes you, even if you:
Have been vaccinated against HPV
Are not currently sexually intimate with anyone
Have had a long time since last having sexually intimate contact
Have only had 1 partner, or only 1 partner for a long time
Haven’t ever had penis-in-vagina sex, but have had intimate sexual contact (as described above)
Don’t identify as a cis hetero woman
Are pregnant
Have had a baby
Are menopausal, or post-menopausal
Have no symptoms (that’s the point – if you have symptoms then we NEED a clinician collected CST)
Certain people require more frequent testing. If you have HIV or have a solid organ transplant, you require screening every 3 years.
More frequent screening can also be considered for you if you:
Were born with an immune system deficiency
Have an autoimmune disease (for example, Ulcerative colitis, Crohn’s disease, Lupus, rheumatoid arthritis, sarcoidosis) AND are being treated with immunosuppressants.
Have received an allogenic bone marrow transplant AND are being treated for graft vs host disease
Am I eligible for Self Collected CST?
Self collection of CST is an option for people who are due (or overdue) for their routine CST. This means that it’s for you if:
your last test was 5yrs ago, and no HPV was found
you have never had a CST
your test was more than 5 years ago, maybe even a Pap Smear (pre-December 2017), and you believe it was normal
A self-collection of CST is NOT suitable for you if you have:
Vaginal bleeding after sex (“post coital bleeding”)
Vaginal bleeding between your periods (“intermenstrual bleeding”)
Vaginal bleeding when you are post-menopausal, which means it’s been more than 12 months since your last period (“post-menopausal bleeding”)
Unexplained, persistent, and unusual vaginal discharge
Unusual pain in your vagina or pelvis
Had HPV in the past and are needing a test of cure
Ever been treated for adenocarcinoma-in-situ (AIS) – this is a cancer
Had a total hysterectomy (removal of the uterus and cervix) AND have previously been diagnosed with a “high-grade squamous intraepithelial lesion (HSIL)”
Been exposed to diethylsttillbesterol (DES) in utero
What are the results of Cervical Screening Tests?
No HPV (>90%) = return in 5yrs.
HPV Non-16/18 (~6-7%) = require a clinician collected sample to assess cells (people aged 70-74 with this result need to be referred for colposcopy).
HPV 16 or 18 (~2-3%) = require referral for colposcopy. Often a clinician collected sample can expediate review if there are associated cell changes.
The Cancer Council website has more information about understanding your Pap smear or cervical screening test results and what your screening test results mean for you.
Visit the Cancer Council Website >>>