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Human papillomavirus

The Human Papilloma Virus (HPV) test is used to screen for cancer of the cervix. Although HPV infection is very common and often clears up naturally, some of the more than 100 types of virus have the potential to cause cervical cancer. If your HPV test identifies that you have one of these high-risk viruses, your sample will be examined under the microscope to look for pre-cancerous changes (called intraepithelial neoplasia) or cancer. The results of this test will decide whether you need to be monitored or actively investigated for possible cervical cancer. The accuracy of the HPV test means that women between the ages of 25-75 only need to repeat the HPV test every five years after their initial test.

The HPV test is used to detect high risk strains of HPV that can cause cancer of the cervix, the lower part of the uterus or womb. 

The human papilloma virus is very common in both men and women, particularly people who are sexually active.  In the majority of cases it will cause few symptoms and the infection will clear up naturally – just as the body gets rid of cold and flu viruses. 
For some people, the virus can cause skin warts, genital warts and laryngeal (throat) polyps. It has also been proven as a contributing cause of oral, anal, cervical, penile, and other forms of genital cancer. There is a risk that in about 15 percent of cases, it may develop into cervical cancer. Recognising this risk, a national screening program for women between the ages of 25 and 74 has been in place since 1991. 
As well as being used as a population screening test, the HPV test is used to investigate abnormal vaginal symptoms such as:
  • Vaginal bleeding other than normal menstrual bleeding
  • Abnormal vaginal bleeding
  • Pain during or following sexual intercourse
  • Bleeding or other discharge during or following sexual intercourse

The sample collected by your health provider is sent to the laboratory where a genetic test is used to detect the DNA of high-risk strains of HPV. If one of the high-risk strains is detected, the same sample is sent to another department where it is examined under the microscope to look for precancerous changes to the cells (intraepithelial neoplasia) or cancer.  

 Sample

A sample of cells is taken from the cervical area during a pelvic examination, using a type of spatula, swab, or brush. The cells are transferred to a special preservative liquid and are transported to the laboratory for HPV testing.

New changes to the National Cervical Screening Program mean that all women aged 25 to 74 can choose to have a Cervical Screening Test either by:

  • taking your own sample from your vagina, using a simple swab (self-collection) or
  • having a healthcare provider collect your sample from the cervix using a speculum.

Both options are covered by Medicare. If you decide to collect your own vaginal sample, you will be provided with a swab by your healthcare provider and instructions on how to do the test. You will be able to collect your sample in a private space.

 

Any preparation?

None

The genetic test is programmed to detect high risk types of the HP virus. They are classified:

  • HPV types 6 and 11 typically cause venereal warts, but (along with types 42, 43, and 44) have a low risk of progressing to cancer.
  • HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82 have a higher risk of progressing to cancer.

If your test identifies you as being at high risk, there is no guarantee that the predicted risk is correct because other factors are involved in development of cancer.  

If the test detects high-risk HPV virus, your sample will be sent to another department in the laboratory where a cytologist, a pathologist with special training in cervical cancer, investigates it under the microscope to see whether cells are changing and becoming precancerous. Treatment may include monitoring over a period of months to see if they return to normal, cryosurgery that freezes and destroys infected cells, or procedures that remove the cancerous tissue. The HPV genetic test will be used to monitor your progress.
 

The choice of tests your doctor makes will be based on your medical history and symptoms.   It is important that you tell them everything you think might help.

You play a central role in making sure your test results are accurate. Do everything you can to make sure the information you provide is correct and follow instructions closely.

Talk to your doctor about any medications you are taking. Find out if you need to fast or stop any particular foods or supplements. These may affect your results. Ask:

  • Why does this test need to be done?
  • Do I need to prepare (such as fast or avoid medications) for the sample collection?
  • Will an abnormal result mean I need further tests?
  • How could it change the course of my care?
  • What will happen next, after the test?

Before 1991, it was up to a woman and her doctor to decide on whether to have a cervical screening test. From 1991, a national coordinated approach was established with the National Cervical Screening Program (NCSP) which included tests for women aged 18 - 70 years, every two years. 

This used the cervical smear or the Pap test which relied on sampling cells directly from the cervix. Although highly successful, the test needed to be done every two years, as it was possible that the sample may miss some HPV-affected cells.  In November 2017, a genetic test replaced the Pap test as the first line in screening for the prevention of cancer of the cervix in women. This could detect the presence of Human Papilloma Virus (HPV) test in a sample.  Being far more accurate than the Pap test it only needed performing every five years.

The risk of developing cervical cancer has been greatly reduced through the introduction of an HPV vaccine, Gardasil® for all females and males aged 12-13 through the Human Papillomavirus (HPV) Immunisation Program. Since the program started there has been a significant fall in the numbers of vaccinated women developing precancerous changes or cancer of the cervix. 

Pathology and diagnostic imaging reports can be added to your My Health Record. You and your healthcare provider can now access your results whenever and wherever needed.

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