Getting the HPV vaccination
The HPV vaccine can help prevent cervical cancer. The HPV vaccine protects against infection with some types of HPV, which are the major cause of cervical cancer.
The HPV vaccines currently available in Australia are called Gardasil 9 and Cervarix.
Gardasil 9 protects against nine types of HPV:
- Two types that are the main causes of cervical cancer in Australia (types 16 and 18)
- The five next most common types that are associated with cervical cancer (types 31, 33, 45, 52 and 58)
- Two types that cause 90% of genital warts (types 6 and 11).
Cervarix protects against two types of HPV that are the main causes of cervical cancer (types 16 and 18).
Both types of vaccine are very safe and very effective.
Who should be vaccinated?
HPV vaccine is most effective when it’s given to young people before they become sexually active. This is because HPV infection often occurs around the time a person starts having sex, and the vaccine only protects people who have not been exposed to those types of HPV before.
Girls and boys aged 12–13 can receive the HPV vaccine for free under the National Immunisation Program at their school.
Females up to age 45 can be vaccinated by their doctor, but there may be a cost involved. However, because the vaccine only protects people who have never been exposed to those types of HPV, the benefit of vaccinating older people may not be as large – older age groups are more likely to have had more sexual partners and therefore are more likely to have already been exposed to several types of HPV.
Cervical Cancer Screening
The National Cervical Screening Program changed on 1 December 2017, when the 2-yearly Pap test (the Pap smear) was replaced with the 5-yearly Cervical Screening Test.
The Pap smear looked for unusual changes or cancer in the cervix. The Cervical Screening Test looks for HPV, a common infection and the cause of almost all cervical cancers.
Cervical Screening Test
The Cervical Screening Test is a simple process that collects a sample from your vagina or cervix to test for signs of HPV.
The Cervical Screening Test can find HPV or changes in the cervix early so they’re easier to monitor or treat before cancer has a chance to develop.
Screening Options
If you are eligible for a Cervical Screening Test, you have the choice to either:
- do the test yourself using a thin, soft swab to collect a sample from your vagina; or
- have a doctor or a nurse take a sample using a speculum to access your cervix.
Both options are safe and accurate at detecting HPV.
The self-collected test sample only checks for HPV. If HPV is found, you may need to return for a doctor-collected test to investigate further.
The doctor-collected test sample is also checked for HPV. If HPV is found, the same test sample can be used to look for any further cervical cell changes.
If you have symptoms such as unusual vaginal bleeding or discharge, your doctor or nurse may advise you to let them 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.
Why do we look for HPV?
HPV can be passed through various types of skin-to-skin sexual contact. It is a very common virus – over 80% of people will have HPV at least once in their lives. HPV is the cause of almost all cervical cancers.
While most cases of HPV clear up on their own, in some cases it can stay in your system for a very long time or lie dormant and reactivate later in life.
HPV can cause changes to cells in your cervix over time, sometimes over 10-15 years. These changes may develop into cancer if they are left untreated.
HPV and early cell changes rarely show any symptoms, which is why routine Cervical Screening Tests are so important.
There are many types of HPV and not all types of HPV cause cancer. The HPV vaccine does not protect against every type of HPV that can cause cervical cancer. You should do cervical screening even if you’ve had the HPV vaccine.
Who should have a Cervical Screening Test?
You should have a Cervical Screening Test every 5 years if you:
- are a woman or person with a cervix; or
- are aged 25 to 74 years old; or
- have ever had sexual contact.
This includes people who:
- have or have not had the HPV vaccine; or
- are pregnant or have had a baby; or
- identify as lesbian, gay or bisexual; or
- are non-binary, transgender or intersex and have a cervix; or
- have a mental or physical disability.
You should start testing at age 25, but it’s never too late to start. Following your first Cervical Screening Test, you should screen every 5 years until age 70-74. After this age, the risk of developing cervical cancer is very low and you can usually stop cervical screening.
If you have had a hysterectomy or partial hysterectomy, you should discuss whether you need a Cervical Screening Test with your healthcare provider.
If you have symptoms at any age, such as abnormal vaginal bleeding, pain or discharge, you should discuss these with your healthcare provider immediately, regardless of when you had your last Cervical Screening Test.
To learn more about the Cervical Screening Test, talk to your doctor or visit the National Cervical Screening Program website.
Where can you get a Cervical Screening Test?
Cervical screening is organised through a healthcare provider, including the self-collect option.
You can get a Cervical Screening Test at different places Australia-wide, including:
- a doctor’s clinic (GP); or
- a community health centre; or
- a women’s health centre; or
- a family planning clinic; or
- a sexual health clinic; or
- an Aboriginal Medical Service or Aboriginal Community Controlled Health Service; or
- a Refugee Health Clinic.
You can also do cervical screening with a gynaecologist, or a nurse trained in cervical screening.
When booking your appointment, you can tell your health practice or clinic if you would like to do the test yourself (self-collect). They may have to order some swabs.
How is a Cervical Screening Test done?
Self-collected test:
Self-collection of a Cervical Screening Test sample is an option for all people who do not show any cervical cancer symptoms. It is usually a more comfortable and acceptable option.
Self-collection is done through your doctor or nurse. If you are eligible and choose to do the test yourself, they will give you detailed instructions.
Your doctor or nurse will give you a swab and somewhere private to do the test, for example behind a medical curtain, in an empty room, or in a bathroom.
The self-collected test uses a thin swab, to collect a sample for testing from your vagina. The soft end of the swab is inserted 4-5 cm into your vagina and rotated for 20-30 seconds. You do not need to reach your cervix because HPV can be detected from your vagina.
When finished, put the swab back in its tube and give it to your doctor or nurse. They will send it to the pathology lab for HPV testing and talk to you about your results.
View detailed instructions on the National Cervical Screening Program website.
Clinician-collected test:
Your doctor or nurse will use a device called a speculum to open your vagina and get access to and visualise your cervix.
Your doctor or nurse will use a small brush to take a sample of cells from your cervix.
The doctor-collected test should only take a few minutes. It may feel uncomfortable. Tell your doctor or nurse if you feel too much pain.
You doctor will send your test sample to the pathology lab for testing and talk to you about your results.
What do the results mean?
Your doctor or nurse will inform you of the results. They will tell you if you need further tests or treatment. Read more on understanding your Cervical Screening Test results.
If your results show no HPV was found, you can return in 5 years for your next Cervical Screening Test. You should continue cervical screening until age 70-74.
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 should be done as soon as practical and can be either a self-collected or doctor-collected test.
If your results show a type of HPV less likely to cause cervical cancer was found:
- if you had a doctor-collected test: your test sample will be further investigated at the pathology lab to determine if any cell changes have occurred. Depending on the results of this investigation, you will either be required to repeat the test in 12 months or be referred to a specialist; or
- if you had a self-collected test: you will need to return for your doctor or nurse to do a doctor-collected test. This should happen ideally within 6 weeks of getting your original results. Following this test, you will either be required to repeat the test in 12 months or be referred to a specialist.
If your results show a type of HPV that may eventually cause cervical cancer was found, you may be required to return to your doctor or nurse for further testing or to be referred to see a specialist.
If needed, your doctor will refer you to a specialist for a follow-up test called a colposcopy test. This is usually done by a gynaecologist. Your doctor can help you decide who to see for a colposcopy.
It is very important you follow the instructions of your doctor for all test results. You can also talk to them if you have any questions about your result.
