TAKE ME TO INFORMATION
It’s your Cervical
Screening Test
Why screen?
Cervical cancer is preventable.
The Cervical Screening Test is a simple process that looks for signs of the human papillomavirus (HPV), a common infection that causes most cervical cancers.
Most cases of HPV clear up on their own, however, sometimes it can develop into cancer.
The HPV vaccine does not protect against every type of HPV that can cause cervical cancer. It’s important to have Cervical Screening Tests, even if you’ve had the HPV vaccine.
Over 70% of cervical cancers occur in people who have never screened or aren’t up to date with their screening.
You should have a Cervical Screening Test every 5 years if you:
- Are a woman or person with a cervix
- Are between age 25-74 and
- Have ever had sexual contact.
What is Cervical Cancer?
The cervix is the organ that connects the vagina/front hole and the uterus (womb). Cervical cancer is the growth of cancerous cells in the lining of the cervix. This growth is usually caused by a HPV infection that stays in the body for a long time. Not all types of HPV cause cancer.
Changes that cause cancer can happen slowly, sometimes over 10-15 years. HPV can stay in the body without symptoms and then reappear later in life.
Cervical cancer usually shows no symptoms in its early stages. That’s why it’s important to do your Cervical Screening Test every 5 years.
The Cervical Screening Test can find HPV or changes in the cervix early making them easier to monitor or treat.
Where to screen?
You can get a Cervical Screening Test at many places such as:
-
- Your local GP clinic
- A community health centre
- A women’s health centre
- A family planning clinic
-
- A sexual health clinic
- An Aboriginal Medical Service or Aboriginal Community Controlled Health Service
- A Refugee Health Service
THE CERVICAL SCREENING TEST PROCESS
When you have a Cervical Screening Test, you have two options:
- Do the test yourself using a small self-swab to collect a sample from your vagina/front hole.
- Have a doctor or a nurse take a sample using a speculum to access your cervix.
When booking your appointment, you can tell your health practice or clinic if you would like to do the test yourself. They may have to order some swabs.
You can also ask to see a doctor or nurse you feel comfortable with to speak about screening.
1. Appointment
At your appointment, you will be in a private room with your doctor or nurse. You can ask questions and talk to your doctor about your testing options.
If you choose to do the test yourself, your doctor or nurse will give you the swab and instructions on how to do the test.
You will be given a private space, such as a bathroom or behind a curtain, to collect your sample.
If you have symptoms such as unusual bleeding from your vagina/front hole, your doctor or nurse may have to do the test for you using a speculum. Let your doctor or nurse know if you have any unusual symptoms so they can investigate them for you.
2. The test
The Cervical Screening Test collects a sample of cells to be tested for HPV. Both methods of collection (self-swab and doctor-collected) are both accurate at detecting HPV.
No matter the method you choose, your doctor will send your test sample to a pathology lab and get your results.
3. Test result
Your doctor or nurse will inform you of the results. They will tell you if you need further tests or treatment.
If your results show HPV was found, you may be required to return to your doctor/nurse for further testing or be referred to see a specialist.
If your result was ‘unsatisfactory’, it does not mean there is a problem. It means the lab was unable to check your test adequately. You will be asked to return for another Cervical Screening Test. This test can be either a self-swab or doctor-collected.
If your result show no HPV was found, you return in 5 years for your next Cervical Screening Test. You should continue cervical screening to prevent cancer until age 70-74. After this age, the risk of developing cervical cancer is very low and you can stop cervical screening.
The National Cancer Screening Register (NCSR) will send you a reminder to screen at 4 years and 9 months after your last screen. The reminder may be via letter or SMS text message.
You can check when you’re due by talking to your doctor or using the NCSR’s Participant Portal (via my.gov.au). You can also call the NCSR on 1800 627 701.
If you have any symptoms of cervical cancer between your cervical screenings, speak with your doctor as soon as possible. Symptoms of cervical cancer include bleeding after sex, unexplained bleeding between periods or any bleeding after menopause.
How to do a self‑swab
Cervical Screening Test
The self-swab method gives you more control over your Cervical Screening Test.
1
Preparing the swab
Your doctor or nurse will explain how to do your own test.
You will be given a swab and somewhere private to do the test, for example behind a medical curtain, in an empty room, or in a bathroom.
2
Inserting the swab & doing the test
The self-swab test uses a soft swab with a cotton bud at the end.
You insert the cotton bud end of the swab 4-5 centimetres into your vagina/front hole. There is a red line on the swab to show how far you need to insert it. Then move and rotate the swab in your vagina/front hole for 20-30 seconds.
Remember you can be gentle with your movements. It won’t impact your results.
If you feel pain, please tell your doctor or nurse.
3
Storing & sending the test
When finished, put the swab back in its tube. Then give it to your doctor or nurse. They will send it to the pathology lab for testing.
(credit: www.health.gov.au/ncsp)
Doctor-collected
Cervical Screening Test
1
Preparation
For this process, you will need to remove your clothing below the waist.
Lie on your back with your knees apart. A sheet will be provided for your privacy. If you are not provided a sheet, you can ask for one.
If you prefer, you can ask for a woman or a doctor/nurse you feel comfortable with to do your test.
2
Inserting the device to access your cervix
Your doctor or nurse will insert a speculum to access your cervix. It may feel uncomfortable. Tell your doctor or nurse if you feel pain.
You can insert the speculum yourself if that is more comfortable for you.
3
Taking the sample
Your doctor or nurse will use a small brush to take a sample of cells from your cervix. The sample will be sent to the lab for testing.
(credit: www.health.gov.au/ncsp)
Cervical Screening Test
vs. the Pap smear?
In 2017, the Cervical Screening Test replaced the Pap test (aka the Pap smear) in Australia.
- The Pap smear looked for unusual changes or cancer in the cervix.
- The Cervical Screening Test looks for HPV which is a common virus and the cause of almost all cervical cancers.
By detecting HPV early, the Cervical Screening Test allows for treatment of cell changes to prevent cervical cancer from developing.
Have a cervical screening test every 5 years from 25-74 if you have ever had any sexual contact
Having a Cervical Screening Test every 5 years from the age of 25 is the best way to protect yourself from cervical cancer.
You should start testing at age 25. Cervical cancer is rare in people under 25 years old. However, if you develop symptoms of cervical cancer before 25, you should see your doctor. Symptoms of cervical cancer include bleeding after sex or unexplained bleeding between periods.
Most people won’t even know they have HPV and show no symptoms. Most of the time, the body will naturally clear the HPV infection on its own.
In some cases, HPV can stay in the body for a long time or lay dormant and reactivate later in life.
It is recommended you have a Cervical Screening Test every 5 years until you’re age 70-74. That is the best way to find any HPV before it becomes cancer.
How do I know when I’m due for my next test?
The National Cancer Screening Register (NCSR) sends an invitation to start screening when you turn 25 and sends reminders when your next test is due.
You can check when you’re next due and make sure your contact details are up to date by using the NCSR’s Participant Portal (via my.gov.au) or calling 1800 627 701.
The register collects your info from Medicare. If your name does not match your Medicare card, you can change it in the National Cancer Screening Register by calling them. You can also update your details and nominate a healthcare provider if you want.
Who needs to screen?
IF YOU ARE A WOMAN OR A PERSON WITH A CERVIX, YOU’RE AT RISK OF CERVICAL CANCER
If you’re a woman or person with a cervix and you’ve ever had sexual contact, you should have a Cervical Screening Test every 5 years from the age of 25.
This is regardless of your HPV vaccination status, number of sexual partners, gender of sexual partners, or whether you’re currently sexually active.
IF I DON’T HAVE A CERVIX,
SHOULD I STILL DO CERVICAL SCREENING?
If you’ve had a full hysterectomy and don’t have a cervix, talk to your doctor or nurse about whether you need to continue to do cervical screening.
If you’ve had a partial hysterectomy, you may need to continue cervical screening.
No matter the type of hysterectomy you’ve had, please see your doctor or nurse to discuss if you need to continue cervical screening.
I’m trans / gender diverse / nonbinary, do I need to screen?
Anyone with a cervix who has had any type of sexual contact is at risk of cervical cancer. If you have a cervix, you should have a Cervical Screening Test every 5 years from the age of 25.
WHAT IF I'M ON TESTOSTERONE?
Being on testosterone does not reduce your risk of developing cervical cancer.
For some people on testosterone, they can experience dryness or irritation of the vagina/front hole. This can make it more difficult to get a quality cervix sample.
If getting a doctor-collected test, you can request a topical oestrogen from your doctor to treat dryness and irritation and make the test more comfortable for you. Your doctor should explain that the treatment is temporary and typically has minimal side effects.
You can also self-swab your test if you prefer. Ask your doctor if you need further help with the self-swab method.
MY MEDICARE GENDER IS ‘MALE’ AND I HAVE A CERVIX. WILL I BE ADDED TO THE REGISTER?
If your registered sex with Medicare is male and you have a cervix but have never had a Cervical Screening Test, you will not automatically be sent an invitation to begin cervical screening when you turn 25.
If you’re 25 or older, you can talk to your doctor or nurse about screening. They can add you to the National Cervical Screening Register. You will then be sent cervical screening reminders when you’re due. Some medical centres and doctors will also send out reminder texts for cervical screening.
If you’ve had a Cervical Screening Test at any point in your life, you will have been added to the National Cancer Screening Register (NCSR), even if your sex is registered as male with Medicare.
If you need to change your personal details on the NCSR, you must change them through Medicare. You can call on 132 011, check your Medicare account here, or use your MyGov account to change your details.
DO TRANS WOMEN NEED TO SCREEN?
If you don’t have a cervix there is no need to screen.
If you are unsure whether you need to have a Cervical Screening Test, please speak to your doctor.
Visit TransHub to find a gender-affirming doctor.
Tips to make screening easier for you
Cervical screening is the best way to protect yourself from cervical cancer. You only have to screen every 5 years.
Some people find cervical screening challenging and uncomfortable.
Here are some tips that may help you feel more confident to do the test.
FIND A DOCTOR YOU TRUST
DOWNLOAD OUR DOCTOR’S LETTER
Sometimes it’s not easy to speak up about the healthcare and treatment we need.
You can use these letters written by ACON to express your Cervical Screening needs.
TAKE A SUPPORT PERSON WITH YOU
You can bring a friend, loved one, or family member with you for support. They can provide emotional support, help distract you, offer a hand to hold, or speak up for you.
Talk to your support person about the support you might need and your screening preferences.
COMMUNICATING WITH YOUR DOCTOR
You may find it helpful if your doctor or nurse explains every step or you can look at an online instruction guide or video.
You can ask the doctor or nurse to stop at any time. You may tell them a word or phrase at the beginning of your appointment to let them know you want to stop.
ASK FOR ACCESSIBILITY
You can ask the staff for help making your test accessible and comfortable.
You can practice how you want to communicate your needs to your doctor or nurse.
You have the right to feel safe, respected, and empowered in any healthcare setting.
LANGUAGE
During the test, you might prefer particular words to describe your body. You can write those words down, and share them with your support person, and doctor or nurse.
You may prefer specifically gender-neutral language like ‘bits’, ‘genitals or ‘junk’. If you want specific language that affirms your gender, please share that with your doctor.
ASK FOR HELP WITH SELF-SWAB
If you are unsure about doing your own swab test, you can ask your doctor or nurse for help.
Your doctor or nurse can be in the room with you and talk you through the process.
The doctor or nurse can also use the self-swab to take a sample from your vagina. Discuss your options with your doctor or nurse.
YOU’RE IN CONTROL
If you’re doing the test yourself, you can ask to do it in a private space that feels comfortable for you. This may be in the office behind a curtain or in the clinic bathroom.
If you’re having a doctor-collected test and it feels very uncomfortable, you can ask the doctor or nurse to stop at any time.
COMFORT WHEN THE DOCTOR DOES YOUR SCREENING
If you are having a doctor-collected test and lying flat on your back feels uncomfortable or vulnerable, you can ask to sit up slightly. You can also request a sheet to be laid over your legs.
If you feel very uncomfortable, you can ask the doctor or nurse to stop at any time. You might be able to take a short break or try again another day.
BOOK A LONGER APPOINTMENT IF YOU NEED
If you think you may need more time, you can book a longer appointment. You can also book separate appointments: 1) to discuss your cervical screening options, and 2) to do the test.
The cost of your appointments depends on your clinic’s fees. You can ask if there are any extra costs like consultation fees when making your appointment.
TAKE YOUR TIME
If you’re doing your own test, you can take your time. You can ask to do it in a private space that feels comfortable for you.
Your doctor or nurse can provide an instruction guide to assist you.
FREQUENTLY ASKED
QUESTIONS
WHAT IF I HAVE CERVICAL CANCER SYMPTOMS?
The Cervical Screening Test is a test for people who don’t have any symptoms.
If you have symptoms see a healthcare provider right away. Symptoms may include:
- vaginal/front hole pain
- unusual vaginal/front hole bleeding
- pain during sex
- unusual vaginal/front hole discharge
IS THE SELF-SWAB TEST LESS EFFECTIVE OR ACCURATE?
A self-swab test is just as accurate and effective at finding HPV as a doctor-collected sample.
The self-swab test sample only checks for HPV.
If HPV is found, you will need to return for a doctor-collected test to investigate further.
The doctor-collected test sample is also checked for HPV. However, if HPV is found, this same test sample can be used to look for any further cervical cell changes.
HOW DO I KNOW I AM SWABBING THE RIGHT SPOT?
With the self-swab option, you do not need to reach your cervix. The self-swab test looks for HPV, which can be detected from the vagina/front hole. The swab only needs to be inserted 4-5cm into your vagina/front hole, and usually has a line indicator on it.
Your doctor or nurse can offer guidance to make sure the test is done correctly and provide help if you need it.
WILL SELF SWAB KITS BE SENT TO EVERYONE BY MAIL?
No, the National Cervical Screening Program is not currently running a home mail-out program.
You need to consult with a clinician or GP to obtain a self-swab test.
Having a doctor involved means you are supported, your test will be handled correctly, and any follow up can be organised.
HOW CAN I MAKE THE TEST MORE COMFORTABLE FOR ME?
Think about what might make your screening experience more comfortable.
You can tell the staff if you want:
- A female doctor or nurse
- A longer appointment or to take a short break during the appointment
- Interpreter services (including Auslan)
- A quiet environment with less noise, light, or smells
- A few minutes alone after the test
- If you want silence during the test or if you want small talk
Remember this is your body and you are in control of your test. You have the right to ask for what makes you the most comfortable.
WHAT IS HPV?
HPV is a very common virus. Over 80% of people will have it at least once in their lives.
HPV can be passed through various types of skin-to-skin sexual contact. This includes vaginal/front hole sex, anal, oral, genital skin-to-skin contact, fingering, fisting or sharing sex toys.
HPV can stay inactive in your body for a long time, possibly without any symptoms. This makes it difficult to know when or how the virus was contracted.
IF I HAVE HPV, WILL I GET CANCER?
In most cases, no. Most people’s immune systems fight off the virus within about 1–2 years, without any effect on their health and often with no symptoms.
For some people, HPV can stay in the body for a long time and reappear later in life. If the virus stays in the body for a long time, it could lead to cell changes and may develop into cervical cancer.
HPV typically takes a long time to develop into cervical cancer, sometimes decades. However, in some cases, it can change faster than usual.
This is why screening is important to detect HPV and treat any changes to prevent cancer.
WHAT HAPPENS IF HPV IS FOUND ON MY TEST?
If your test results show HPV, your doctor or nurse will give you guidance on next steps.
If you did your own test, you may need to come back for a doctor-collected test. The doctor-collected test can take a sample from your cervix to detect any further changes caused by the HPV.
The results of these tests will determine if further investigations or treatments are necessary to prevent cervical cancer.
You might need to return in a year for a follow-up Cervical Screening Test to see if the HPV infection has cleared. You might also require a colposcopy, a special exam of your cervix which may include a biopsy.
To learn more about what happens after your test and what different results can mean visit Australian Government Department of Health and Aged Care.
I ONLY HAVE SEX WITH WOMEN, DO I NEED A CERVICAL SCREENING TEST?
Yes. Anyone with a cervix who has ever had sexual contact of any kind, with anyone should have a Cervical Screening Test every 5 years from age 25-74.
HPV can be passed through various types of sexual contact. The gender of your sexual partner is not a factor for getting a HPV infection.
MY DOCTOR TOLD ME LESBIANS DON’T NEED A CERVICAL SCREENING TEST. IS THAT TRUE?
This is not true. You may encounter some doctors or nurses who believe lesbians don’t need cervical screening since they do not have sex with men or people with a penis.
If you have a cervix, you should have a Cervical Screening Test. It’s important to do cervical screening no matter the sexual contact you engage in or gender of your sexual partner.
If your doctor or nurse says you don’t need cervical screening, you can use this general letter to outline your request for cervical screening.
If you would like to find a LGBTQ+ friendly doctor to discuss cervical screening, see DocDir or TransHub.
IF I HAVE HPV, HOW DO I PROTECT MY PARTNERS?
Because HPV can be spread through skin-to-skin sexual contact, not all methods of standard protection are completely effective.
Condoms offer limited protection against HPV because they do not cover all genital skin. However, they do provide excellent protection against infections such as chlamydia, gonorrhoea, and HIV.
Getting the HPV vaccine and doing cervical screening is the best way to protect your health.
IS THERE A CURE FOR HPV?
No. There is currently no cure for HPV. However, there is treatment available for the pre-cancerous cell changes caused by HPV.
The HPV vaccine does not protect against every type of HPV that can cause cervical cancer. This is why it’s important to do Cervical Screening Tests, even if you’ve had the HPV vaccine.
If you do get HPV, the virus usually clears up on its own after 1-2 years, but screening is the only way to be sure your body has cleared the virus.
WHAT ABOUT CERVICAL CANCERS THAT AREN’T CAUSED BY HPV?
Most cervical cancers are linked to or start from HPV.
Cervical cancers not caused by HPV are very rare, but they do exist. This is why it is important to tell your doctor or nurse if you notice symptoms like bleeding after sex, unexplained bleeding between periods, any bleeding after menopause or any unusual vaginal/front hole discharge.
If you do not have symptoms, doing a Cervical Screening Test every 5 years is the best way to reduce your risk of developing cervical cancer.
WHAT IF I’M HIV POSITIVE OR IMMUNE DEFICIENT?
HIV and other conditions may affect your immune system’s ability to clear HPV infections. Your risk of cervical cancer may be higher.
If you’re HIV positive, have a condition that affects your immune system, or you are being treated with medications for autoimmune conditions, please talk to your doctor to discuss if you need to get tested every 3 years instead of 5 years.
ARE THERE COSTS FOR THE CERVICAL SCREENING TEST?
If you have a Medicare card and you are due to screen, Medicare offer a full rebate for your Cervical Screening Test.
The cost of your appointment depends on whether your doctor bulk bills or charges consultation fees. The cost also depends on whether they use a pathology lab that bulk-bills Cervical Screening Tests through Medicare.
You can ask if there are any extra costs when making your appointment.
For example, you can ask:
- “Am I due for my cervical screening test?”
- “Do you bulk bill cervical screening consultations?”
- “Can you send my pathology requests to a lab that doesn’t charge gap fees?”
WHAT IF I DON’T HAVE A MEDICARE CARD?
If you do not have a Medicare card, you may receive an invoice for the test and/or pathology lab assessment. Discuss costs with your doctor or nurse when booking your test.
International students with overseas student health cover (OSHC) will have their pathology lab costs covered. You may need to pay for the tests and then seek reimbursement from your insurance provider.
If you are a refugee or asylum seeker in need of free services, please refer to Services Australia and the Refugee Health Network of Australia.
I LIVE WITH A DISABILITY, CAN I STILL SCREEN?
Yes. If you have a cervix, and have ever had sexual contact, then you need to have a Cervical Screening Test every 5 years from age 25 to 74.
You can bring a friend, family member, caregiver, or support person to your appointment. You can also book a longer appointment, so you don’t feel rushed.
Be sure to tell staff about any specific needs you may have. You can also ask for help to complete the self-swab option, if you prefer.
WHAT HAPPENS AFTER YOU TURN 70?
Individuals aged 70 to 74 are encouraged to do a final Cervical Screening Test to check cervical health and the absence of HPV.
After this age, the risk of developing cervical cancer is very low and you can stop cervical screening.
CAN I DO A CERVICAL SCREENING TEST WHEN I’M ON MY PERIOD?
Yes, you can have a Cervical Screening Test at any point in your menstrual cycle. Please note that very heavy bleeding can interfere with the test results.
Many women and people with a cervix find it more comfortable to schedule their test when they are not menstruating. Whether you do your test during or not during your menstrual cycle is your choice.
I’M PREGNANT, CAN I STILL SCREEN?
Yes, cervical screening is safe if you are pregnant.
Talk to your doctor or nurse about the best time and screening options for your Cervical Screening Test.
DO I STILL NEED TO DO CERVICAL SCREENING IF I’VE BEEN THROUGH MENOPAUSE?
Yes. It’s important to continue cervical screening until you have your last test when you’re 70-74 years old.
For some post-menopausal women and people with a cervix, hormonal changes in the vagina/front hole can make getting a quality sample from the cervix challenging and uncomfortable.
Your doctor or nurse can prescribe a topical oestrogen before your doctor-collected test to make you more comfortable. This treatment is temporary and usually has minimal side effects.
Otherwise, you can choose to do your own test with a simple swab at the clinic.
I LIVE IN REGIONAL/REMOTE AUSTRALIA, HOW CAN I HAVE A CERVICAL SCREENING TEST?
Living in regional or remote areas may mean cervical screening is harder due to greater challenges to access healthcare and information.
It is important to prioritise screening. Check out options for cervical screening in your local area. These could include mobile or outreach services.
You can also visit Women’s Health Nurses, who play an important role in cervical screening in remote areas.
For more information on locations, hours, and contact details, visit your Local Health District website, Medical Centres, or the Australian Women’s Health Nurse Association.
I HAVE HEARING DIFFICULTIES AND/OR A SPEECH IMPAIRMENT
If you have a hearing or speech impediment, contact the National Relay Service to assist with your cervical screening appointment.
I NEED AN INTERPRETER FOR MY CERVICAL SCREENING APPOINTMENT
You can ask for an in person or telephone interpreter service to help you during your test appointment.
Tell your doctor or nurse you need an interpreter when you book and ask them to organise that for you.
Check with your doctor or nurse that there are no costs with this interpreter service.
Visit the Translating and Interpreting Services or call 13 14 50 for telephone interpreter service.
Get in touch!
Have any questions or need more information?
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