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Will the new self-collection approach help eliminate cervical cancer?

Introduction by Croakey: Cervical cancer self-collection “is a revolutionary step towards eliminating cervical cancer as a public health issue”, according to Diem Tran and Liana Bellifemini from Cancer Council SA.

Tran and Bellifemini write that they hope the self-collection option will see screening rates lift, particularly in under-screened communities, and save lives.

Diem Tran, Prevention Coordinator, and Liana Bellifemini, Senior Prevention Project Officer, outline below important new information about cervical screening self-collection.


Diem Tran and Liana Bellifemini write:

From the start of this month, Australian women and people with a cervix who are eligible for cervical cancer screening have been able to choose to undertake self-collection – or to continue with the usual practice of having a sample collected by their healthcare provider.

Cervical screening self-collection is a game changer for Australia – particularly those in under-screened communities who now have choice and control about how they receive their test.

The option is now available for women and people with a cervix aged 25 to 74 who are due for a cervical screening test. Reassuringly, self-collection is safe and is just as accurate and effective as a sample collected by a GP or nurse.

Participation in regular cervical cancer screening gives you the best chance of detecting cervical cancer early and ultimately, saving your life. Cervical cancer kills 237 people each year in Australia.

Australia’s Cervical Screening Program

Research shows that Australia is on track to eliminate cervical cancer by 2035 through a combination of the Human Papillomavirus (HPV) vaccination – a breakthrough Australian advance – and screening. However, to eliminate cervical cancer, eligible Australians need to get tested every five years.

Through regular screening, cervical cancer can be picked up in the very early stages, or even long before cancer develops.

The Cervical Screening Test is looking for HPV, which is a sexually transmitted virus that causes the majority of cervical cancers in Australia. Most cases of HPV clear up on their own and do not require treatment. However, if some types of HPV remain in the body for a long time, they can cause changes to your cells which can result in cancer.

Long-term infection with HPV and precancerous cell changes, within the cervix, usually have no symptoms. The only way to know if you are at risk of cervical cancer is to have a test.

If symptoms occur, they usually include unusual vaginal bleeding, pelvic pain, pain during sex, a change to vaginal discharge, heavier periods and periods that last longer than usual.

An important part of the National Cervical Screening Program is that each test is recorded on the National Cancer Screening Register, to ensure patients get a reminder when they are due for their next test. GPs can also access the register to see when a patient is due, to avoid unnecessary testing.

Barriers to cervical screening

Many eligible Australians aren’t taking part in regular cervical screening testing. Self-collection has the potential to increase cervical screening rates in under-screened communities and get us closer to eliminating cervical cancer as a public health issue.

Those who are less likely to screen include Aboriginal and Torres Strait Islander women, culturally and linguistically diverse communities, people who identify as LGBTI+, people with disabilities, people who have experienced sexual violence, post-menopausal women and people who have had negative cervical screening experiences.

Data also indicates that cervical cancer screening is lower in some regional and remote communities, where access to health clinics and GPs are limited, particularly for those who prefer a female GP or practice nurse perform their test.

Accessing self-collection

Self-collection isn’t a new thing – the option has been available for a number of years, but with strict eligibility criteria. The change allows self-collection to be available universally.

You should be able to access self-collection anywhere that you would normally have a cervical screening test, such as at your GP or women’s health clinic. When making your appointment, make sure to ask if self-collection is available.

You are due or overdue for your cervical screening test if:

  • you are aged 25 to 74 years, have ever been sexually active and have never been screened for cervical cancer
  • you have not been screened since having your last ‘Pap Test’ (prior to November 2017)
  • it’s been five years since your last cervical screening test.

Ask your GP if you are unsure if you are due, or to find out if self-collection is the right option for you. In some circumstances, such as if you have a previous history of abnormal test results or if you are experiencing symptoms, a cervical screening test provided by a healthcare provider is the only option.

How to do the self-collection test

A self-collection test uses a long-handled cotton swab to collect your own cells from the vagina. The swab for self-collection is different to the ones your health practitioner uses.

Cervical Cancer Self Collection swab. Photo supplied by Cancer Council SA

The test involves simply inserting the swab into the vagina a few centimetres (approximately the same depth as a tampon) and rotating gently one to three times.

You can take this test in private at the GP clinic – in the clinic bathroom or behind a curtain – or at home. Once the sample has been collected, it must be returned to the GP as soon as possible so it can be sent off to be tested.

Self-collection really is a revolutionary step towards eliminating cervical cancer as a public health issue. Our hope is we will see screening rates lift and lives saved.

Visit www.cancersa.org.au/prevention/finding-cancer-early/finding-cervical-cancer-early for more information about self-collection and cervical cancer screening or call Cancer Council on 13 11 20.

About the authors

Diem Tran and Liana Bellifemini are part of Cancer Council SA’s Prevention and Advocacy Team. Cancer Council SA is proud to provide information, education and prevention programs to help all South Australians reduce their cancer risk, while encouraging the community to regularly participate in national bowel, breast and cervical cancer screening programs.

L-R: Liana Bellifemini, Diem Tran

Previously at Croakey: Self-collection: will it be a game changer for cervical cancer prevention?


See Croakey’s archive of articles on cancer.

 

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