Waging a Smear Campaign Against Cervical Cancer

Their calls came following the implementation this month of the National Health and Medical Research Council’s (NHMRC) new guidelines for the management of abnormal pap smears in asymptomatic Australian women.[1]

The new guidelines offer medical practitioners recommendations to manage patients with abnormal pap smears, taking into account new knowledge regarding the human papilloma virus (HPV) infection and its role in cervical cancer.

“The National Cervical Screening Program together with the new NHMRC guidelines are vital tools in maintaining the health of Australian women and raising awareness of the necessity of a pap smear to prevent death from cervical cancer,” said Suzanne Dvorak, Australian CEO of Marie Stopes International.

Australia’s cervical cancer mortality rate is five times lower than the worldwide average and is the lowest in the world. A Pap smear every two years can prevent the most common form of cervical cancer in up to 90% of cases. In spite of this, 36% of women aged 18-70 do not have two yearly Pap smears and three out of four women who develop cervical cancer have either never had a Pap smear or haven’t had one in the past five years.

“Statistics show a decline in screening participation among women aged 20 – 44 years which is of concern given it is the eighth most common cancer affecting women in Australia,” Ms Dvorak said.

“Cervical cancer in indigenous women also remains a serious issue, with mortality rates 5 times higher than for non-indigenous women.”[2]

Research has shown that the majority of low-grade abnormalities are the result HPV - a common infection occurring typically in women between the ages of 18 to 30. The virus is spread via genital skin-to-skin contact, so using condoms or other barrier methods does not prevent transmission. In most cases the body takes between one and two years to clear the virus naturally.

“Around 80% of the population will have HPV at some time, and most will never know unless it is noticed on a pap smear result,” said Ms Dvorak.

“Although a pap smear does not specifically test for HPV, some pap smear results will show that cells of the cervix have been affected by the virus.” she said.

HPV can cause cell changes that may lead to cervical cancer but the virus is unlikely to cause cervical cancer by itself. However, when certain HPV infections take longer than usual to clear from the body, there is an increased risk of cervical cancer. When cervical cancer occurs, HPV is found in almost all cases.

“It is therefore imperative that women have a pap smear every two years so that cell changes can be identified and either monitored or treated well before they may become cancerous,” Ms Dvorak said.

“If you are over 18 and have ever had sex, you should have regular pap smears, even if you are no longer sexually active.

“The crucial thing about screening is to make it a regular part of your life and to continue to screen routinely until you are 70 years old. Early detection is the best prevention when it comes to cervical cancer.”

For more information on pap smears, visit your doctor, Marie Stopes International centre or family planning clinic.

[1] Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen detected abnormalities, NHMRC.

[2] Australian Institute of Health and Welfare (AIHW) 2005. Cervical Screening in Australia 2002–2003.AIHW Cat. No. 26. Canberra: Australian Institute of Health and Welfare (Cancer Series number 31).