Cervical cancer in Australia
In 2021 it is estimated that 913 cases of cervical cancer were diagnosed in Australia. The rates of cervical cancer in Australia have declined thanks to the Cervical Cancer Screening Program which began in 1991, and the introduction of a vaccination program in 2007.
Compared to other countries around the world, Australia’s cervical cancer rates are low, with around 9 new cases of cervical cancer being diagnosed, and 2 deaths per 100,000 women.
The risk of a woman being diagnosed with cervical cancer by the age of 85 is 1 in 162.
The chance of surviving cervical cancer for at least five years after diagnosis is 74%.
About cervical cancer
Risk factors for cervical cancer
There are several risk factors for cervical cancer, but the biggest risk factor is Human Papillomavirus (HPV) infection.
What is HPV?
HPV is a common virus known to cause the majority of cervical cancers, as well as some other health conditions.
What are the types of HPV?
There are more than 100 types of HPV but the majority of these do not cause cervical cancer, the vaccine protects against high risk types.
How common is HPV in Australia?
HPV is a common virus and can often have no symptoms, making it hard to know if you have it, and easy to pass it on without knowing. Around 8 out of 10 women will become infected with genital HPV during their lifetime.
How do women get this virus?
Anyone can get HPV and it is usually passed on by sexual contact.
Find out more about how HPV is transmitted, who is at risk and how to prevent it. [link to ‘about HPV’ article]
What else increases your risk of cervical cancer?
Other factors that can increase your risk of getting cervical cancer are a weakened immune system, as well as smoking and passive smoking. Women living with HIV have a 6 times higher risk of developing cervical cancer. Some older women may also have increased risk; if their mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone oestrogen, during pregnancy (most commonly between 1939 and 1971).
How to reduce your risk of cervical cancer
There are some important actions that people can take for prevention of cervical cancer.
The main things to be aware of are immunisation and getting the Cervical Screening Test.
What is the cervical cancer / HPV vaccine?
The vaccine protects against the Human Papillomavirus that causes most cases of cervical cancer and can also cause other cancers. It is given to young people to prevent HPV infections.
Find out more about the HPV vaccine, how it helps lower the risk of cervical cancer and who vaccination is recommended for.
What are some other ways to prevent cervical cancer?
Women or anyone with a cervix should participate in the National Cervical Screening Program, to help prevent cervical cancer.
About the Cervical Screening Test
Where can you get a Cervical Screening Test in Australia?
The Cervical Screening Test can be accessed through a General Practitioner (GP), or via women’s health clinics and sexual health services anywhere in Australia.
What is a pap smear/ pap test? Is this the same as the Cervical Screening Test?
The Cervical Screening Test used to be called the pap smear in Australia. The sample collection procedure is still the same for the patient and health professional performing the procedure, but we now call it the Cervical Screening Test because the test performed by scientists in the pathology laboratory is different.
The old pap smear test was looking for cells that have already begun to show changes that are either cancerous or could become cancerous.
The new Cervical Screening Test looks for HPV, which catches any problems earlier when they are easier to monitor and treat.
There is no blood test for cervical cancer screening. The test uses a sample of cells from your cervix. However, if you have symptoms that your healthcare professional is concerned about, they may order other tests including blood tests to help them find out what’s wrong and how to treat you.
When should you get screened for cervical cancer / HPV?
The Cervical Screening Test is available to people aged 25-74 who have a cervix and are sexually active, regardless of sexuality. If your test is negative you only need to be tested every 5 years. Because this is a screening test, you do not need to have symptoms to be tested, but if you have any symptoms you should discuss these with a healthcare professional straight away, regardless of your screening status.
What happens in a Cervical Screening Test?
The test involves a sample being taken from the cervix (via the vagina) that is sent to a pathology laboratory for testing. If HPV is detected, then the pathology laboratory will also examine the sample under a microscope to see if any further changes have occurred in the cells. This is called cytology and this is how cervical cancer is diagnosed.
What is the meaning of your Cervical Screening Test result?
The GP or health professional who ordered the test can discuss results with the patient. For negative results, the next screening test is needed in 5 years’ time. If the test result is positive for HPV, a healthcare professional will advise if another procedure such as a colposcopy is needed, or if the patient can wait and be tested again in 6 or 12 months to see if the body has cleared the HPV infection.
Only around 54% of eligible Australians were participating in Cervical Screening Tests in 2018, and numbers are thought to have dropped in recent years due to the pandemic. Australia has the chance to eliminate cervical cancer by 2028 but will need to improve participation in screening to do so.
Are there any common signs and symptoms of cervical cancer?
Most of the time, cervical cancer has no symptoms, particularly in the early stages. This is why the screening program was developed to begin with, to catch cervical cancer at a stage where it could be treated.
If you experience any of these symptoms, please see your doctor;
- Any abnormal bleeding from the vagina. This includes bleeding between periods, bleeding after menopause, having a period that lasts longer or is heavier than usual, or bleeding after sex.
- Pain during sex
- Unusual discharge from your vagina
It is rare for cervical cancer to reach an advanced stage before it is detected however, advanced cervical cancer can cause additional symptoms such as:
- Extreme fatigue
- Leg swelling or pain
- Lower back pain
These symptoms could be caused by something other than cervical cancer, but it is essential to talk to a healthcare professional to find out the cause and get the right treatment.
What types of treatment are available for cervical cancer?
If you have a positive HPV result, depending on the type of HPV you may be referred for another test in 6 or 12 months to see if your body has cleared the infection on its own.
However, for high risk types of HPV some patients will be referred for a colposcopy procedure to closely examine the cervix for any changes. During this procedure a doctor will use an instrument called a colposcope to look for any areas of concern and may take a sample of tissue called a biopsy. This is sent to be examined in a pathology lab under a microscope to check for cancer.
There may be low grade changes in the cervix, known as precancerous abnormalities which require removal of tissue. There are several options that may be recommended such as a LLETZ procedure (large loop excision of the transformation zone) which uses a heated thin wire loop to remove the precancerous cells. There is also laser surgery which is similar to LLETZ but may be more suitable for a larger lesion.
In some circumstances, a cone biopsy might be recommended. This requires a surgeon to remove a cone-shaped piece of tissue from the cervix with a scalpel, this is then sent to pathology to confirm if all the precancerous cells have been removed.
If the cancer is at an advanced stage at diagnosis, further surgical options, chemotherapy, or radiation therapy may be recommended.
Any treatments will depend on the specific pathology results and the patient’s medical history and individual circumstances.
For more information and support visit the Australian Cervical Cancer Foundation’s website.