All women who have ever been sexually active should have regular cervical smear tests between the ages 20 – 70 years of age.
Being part of the National Cervical Screening Programme and having cervical smear tests every three years can prevent cervical cancer. A cervical smear test shows if there are abnormal changes in cells on the surface of the cervix.
Cervical Cancer and the Human Papillomavirus
- Cervical cancer is caused by the human papillomavirus (HPV). HPV is a sexually transmitted infection that affects almost all people at some point in their lives.
- There are many types of HPV. Most HPV infections will clear up by themselves.
- Only a few types of HPV will lead to abnormal, precancerous cells that could progress to cancer.
- Although there is no treatment for persistent HPV infections, there is treatment for the abnormal cells that HPV can cause.
Having regular smear tests every three years is the best way of finding and treating abnormal cell changes and preventing cervical cancer from developing.
Who should have cervical smear tests?
All women aged 20 until they turn 70 who have ever been sexually active should have regular smear tests. Women who have had a hysterectomy (removal of the uterus) need to check with their doctor or smear taker whether they still need to have cervical smear tests. Women who have been HPV immunised should continue to have regular cervical smears because the vaccine does not protect against all the virus types that cause cervical cancer.
How often do women need a cervical smear test?
- Women are advised to have a cervical smear test every three years. Research shows very little extra benefit from having more frequent smears.
- Cervical cancer usually takes many years to develop. Any abnormal cells can be found and treated to stop them from becoming cancer.
- If this is your first cervical smear test, or if you have not had a test for over five years, you will be advised to have a second test in a year’s time.
- In some circumstances, you may be advised to have a test more often, eg, after an abnormal result.
About the Cervical Smear Test
You will be asked to lie on your side or your back with your knees bent up. The lower part of your body will be covered with a sheet. The smear taker gently opens the vagina with a speculum and carefully takes a sample of cells from the surface of the cervix with a tiny brush or broom. This process will take only a few minutes. The sample of cervical cells is placed into a liquid solution that preserves the cells for testing (called a liquid-based cytology test or LBC). The sample is then sent to a laboratory to be examined.
Some women may find the test uncomfortable but it does not usually hurt. If you are embarrassed or nervous, tell your smear taker how you feel. You can take a support person with you if you wish It is best not to have the test during your period but instead have it 3 days before or after.
In some situations, woman having a cervical smear test will also be offered an HPV test. The HPV test looks for high risk types of human papillomavirus, which can cause cell changes. The HPV test is performed on the same sample as the smear test. If you have an HPV test, the laboratory reports the results to your smear taker at the same time as your cervical smear result.
Cervical Smear Test Results
Cervical smear tests are a very good screening tool but they are not perfect. There is a small chance that some abnormal cells will be missed during sampling or slide reading (called a false negative). Abnormal changes to cervical cells progress very slowly. It is likely that any abnormal cells missed at one regular check will be picked up at the next.
Some women may be asked to come back for another test if there were not enough cells to test.
If you have an abnormal result you may be called back for other tests. An abnormal result hardly ever means cancer. If a woman has been told her smear is abnormal, she will have a further smear or be referred for colposcopy. The results from these tests may show there are no abnormal cells and no treatment may be needed.
Colposcopy is an examination of the cervix, using a magnifying lens called a colposcope. The colposcope looks like a pair of binoculars on a stand. It magnifies the cervix and vaginal wall so that the abnormal cells can be found.
An important message
See your doctor if you have:
- bleeding or spotting between menstrual periods
- bleeding or spotting after sexual intercourse
- bleeding or spotting after your menstrual periods have stopped (after menopause)
- persistent pain in your pelvis
- pain during sexual intercourse
- unusual discharge from the vagina. The discharge might be smelly, have changed colour from white to pink, brown, or green, or be streaked with blood.
These symptoms can happen for several reasons and rarely mean that you have cervical cancer. However, they should be checked by your doctor
The National Cervical Screening Programme
The programme aims to prevent cervical cancer. All wom who have cervical smears are part of the programme unless they say that they do not want to be.
The benefits of recording cervical smear test information include:
- ready availability of records to you, your smear taker and the laboratory reading your tests
- automatic reminder letters when you are overdue for having a cervical smear test
- checks to ensure the right follow-up after an abnormal smear test
- planning for the needs of different ethnic groups.
The programme is checked regularly to see that it is working well and is measured against national quality standards to help all women get the best possible screening and treatment.
What information is collected?
The information collected by the programme includes your personal and contact details, relevant clinical history, cervical results and any treatment details. This confidential information is stored on a computer system called the NCSP register which is managed by the Ministry of Health. For more information about the legislation governing the NCSP, ask to see the booklet Prevention of Cervical Cancer: A Guide for Women in New Zealand, code HE1328
- Any woman can withdraw from the programme at any time by filling in a form or by writing to the programr
- In order to ensure no follow-up, your name, address date of birth and national health index number will be kept, but the programme will not track your smear history.
- You can rejoin the programme at any time, and your screening history with the programme will recommence with your most recent smear.