Radical Changes to Pap Testing in Australia

As of December 1, 2017, Australia introduced some big changes to its cervical cancer screening program.   The outdated pap test has been replaced with a new HPV test, and intervals between testing have extended from once every two years to testing once every five years.  There is also a new recommended age to begin testing.  Australian women were previously encouraged to begin screening at age 18, but women are now advised to begin screening at age 25.

The reason for the changes is due to the improved accuracy of the HPV test. Experts claim that HPV testing is more accurate than the pap test, and therefore does not need to be done as often (source).

About forwomenseyesonly

Hi. My name is Sue and I am interested in promoting holistic and respectful health care.
Gallery | This entry was posted in pap test, pap test accuracy, unnecessary pap test and tagged , . Bookmark the permalink.

25 Responses to Radical Changes to Pap Testing in Australia

  1. Shelli says:

    Australia’s new guidelines are a start. I can hear all the gynos out there screaming and howling that women still must come in yearly to get their annual rape done. Women in the Netherlands have a home cervical screening test available to them; I wonder if it will be modified to include (or exclusively be) the HPV. I forget if I mentioned it on this site or not; The United Nations World Health Organization has also spoken out very recently calling for the reduction of paps, and questioning the whole getting felt up the vajayjay part. The organization flat out said that pelvics are over done. Their conclusions were scientific, evidence based. The bimanual part detects nothing. It does not detect uterine or ovarian or anything, frankly. But at least this whole subject is starting to get some attention. I, of course, have made the decision that I am done with all this nonsense. Keep fighting the good fight, women! I love all of you!

  2. Kiwicelt says:

    http://www.rivm.nl/en/Documents_and_publications/Common_and_Present/Brochures/Disease_Prevention_and_Healthcare/Cervical_cancer_screening_programme/Screening_for_cervical_cancer_invitation

    The Dutch cervical screening leaflet is here in English. They are so progressive. The leaflet makes it clear that screening is a choice, some women may be harmed. The self HPV test is also offered and they do not screen pregnant women.
    Our new NZ programne encourages smear takers to test pregnant women if they are not up to date. They will not treat pregnant women until after the pregnancy and they admit that a specialist colposcopist is needed to look at the pregnant cervix and that what may present as CIN, readily regresses post pregnancy.
    As suspected, the sheeple are protesting about the raised screening age in Australia and the extended screening age. They cannot work out that those running the screening programmes have known about overtreatment for years. They believe they would not be here if their cervices hadn’t been sliced and diced aged 20 plus.
    I had a discussion with a Doctor telling me that self HPV tests were only an option for those refusing the speculum and a poor second to a physician collected sample.
    The new evidence suggests that PCR self HPV testing is as accurate as a physician collected sample.

    • Thanks Kiwicelt for linking the Dutch cervical screening leaflet. The English leaflet states:
      “When you are between 30 and 60 years old, you will automatically receive an invitation for the free screening every 5 years”. Also, if women between 40 and 50 years old do not test positive for HPV they are invited for screening again in 10 YEARS.
      The leaflet states: “If you do not have HPV, the risk of getting cervical cancer within 10 years is very small. So small, that another smear test in 10 years’ time will give you sufficient protection.”
      The Dutch program helps to highlight how excessive programs are in other parts of the world. They don’t begin screening until age 30, and then scale back to once every 10 years for women between 40 and 50 years old who do not test positive for HPV. And yes, they make if very clear that screening is a choice, and that it might not be the best course of action for all women.
      The fact they don’t screen women when they are pregnant or have just given birth is interesting! They do not explain why this is the case . . .

      • Kiwicelt says:

        Presumably because of the changes to the pregnant cervix.
        I have information from our Updated Guidelines for Cervical Screening in NZ which state ” Changes to the cervix during pregnancy make colposcopic assessment more challenging. Although the squamocolumnar junction (SCJ) and the T zone are more exposed, complete visualisation of all four cervical quadrants is often hindered by oedema, cyanosis, vaginal wall protrusion and thick mucus production. An experienced colposcopist should perform the examination because of the difficulty in differentiating between changes that result from pregnancy and those due to cervical pathology. A less experienced colposcoppist could potentially overestimate the severity of dysplasia, mistakenly diagnose invasive disease and prompt uneccessary investigation during pregnancy”

        The NHS do not encourage screening in pregnancy but NZ are quite happy to get medical professionals to do it.

        Just to say I too, think this site is brilliant.Great to interact with likeminded informed individuals. Thank you.

      • Kiwicelt says:

        The guidelines also say
        “Because treatment is associated with an increased risk of pregnancy complications ‘HSIL’ diagnosed during pregnancy should be treated after delivery. This approach is safe as ‘CIN’ progresses to invasive disease during pregnancy in only 0-3% of cases. Almost all of these cases are micro-invadive and amenable to curative treatment. It is also common for CIN to regress post partum.”

  3. Sophia says:

    I love this website and am really pleased I found it but could I say that the pictures of speculums on this article and elsewhere are really triggering and unpleasant for me.

    I am not able to look at the website some days because I cannot cope with seeing them.

    It would be good if they were removed 🙂

    • Hi Sophia,
      Thanks very much for your feedback. I’m sorry to hear how the picture was affecting you and I have now replaced the speculum picture with an Eve HPV self-test image.
      I am leaving the others in place for a few reasons, including those related to cognitive behavioral therapy (exposure therapy) that some women may find empowering/therapuetic over time. The images do get views, perhaps because some women are simply curious to see what gets inserted, and in this sense might be empowering as well.
      The other pictures are hopefully easier for you to avoid, but I realize the top place position of the now deleted picture would have been more difficult to avoid, and for that reason replaced it with hopefully a less triggering one for you.
      Sue XO

      • Sophia says:

        Hi Sue and thank you for changing the photo 🙂

        Unfortunately I can’t avoid the photos. There are six photos of speculums on the homepage that I see every time I visit. Each article is listed on the homepage and all show the photo for the article. So there is no way to avoid them.

        I understand that some women want to look at them and why.

        I think having them in a separate article/tab (like you have “About” and “References and Education” etc at the top of the homepage) would be better. If women want to see them then they can look but I am not forced to look at them if I want to read the information/support here.

        This should be a safe site but sadly because of the photos it is not and I have to limit the times I visit or avoid it altogether.

    • Amelia says:

      Sophia, you can block images on specific websites by changing settings in your web browser. If you Google “how to block images on a specific websites”, you will find step-by-step instructions on how to do it. That way you won’t have to see the images when you visit the website, but other women will still be able to see them if they want to.

  4. Daia says:

    I remember reading somewhere (maybe here) that HPV tests can be done by a self-swab… which made me wonder why in Aust it still has to be done by a GP with a speculum? The first article on this I read in Aus earlier this year said it would still be with a speculum, and the linked article says women won’t notice any difference with the test, other than that it happens less often now. I supposed the increased accuracy is a positive thing, but I’m still not sure if the invasive nature of the test is warranted.

    • Kiwicelt says:

      Daia there is a self HPV test available for women in the new Australian screening programme.

      http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/6D318177BD8D1D0ECA2581C4001C2F75/$File/CAN180-Quick-Ref-Guide-Self-Collected.pdf

      They are not publicising this. It is only to be offered to women over 30 who are “overdue” by two years or more or who have never screened. I get the impression that Drs are offering it as a last resort if they cannot persuade a woman to accept the speculum. A woman will get one Self HPV test and once on the register, will be directed to a speculum test next time. NZ are not offering self HPV testing when they first roll out Primary HPV testing in 2018.

      • Kiwicelt says:

        If you are in Oz and you choose to screen, be firm and demand a self HPV test. If more of us do this things may slowly change.

      • Daia says:

        Hmmm in a way this kind of makes the whole thing even worse – so even when there are options available for women NOT to have someone poking around inside them, the default is still to go internal…. this really must be some sort of rape… how can anyone ‘consent’ to this procedure if they’re not told there is another option? This whole thing makes me sick to my stomach.

  5. Elizabeth (Aust) says:

    Daia
    That’s right, there’s a self-test option but we’ll be told it’s not as good as a sample taken by a doctor, women who want to self test will have to stand firm, I read somewhere that you’d have to decline the invasive HPV test for 6 years before you’d be offered a self test. They probably hope in that time they can get most women to accept the invasive HPV test.
    The HPV self-test is really just an attempt to get non-screeners on board, the attitude is…”you can’t say no now, he’s a self test option”…
    Wrong, I’ll continue to say NO,
    The program definitely doesn’t want women who currently have pap testing to start doing HPV self testing, so they’ll make it as hard as possible, and mislead women by saying it’s not as reliable.

    There were self test options online, like the Delphi Screener, but I assume too many Aussie women were using them – so they seem to have blocked the sites, that doesn’t surprise me, this is what they do, block all alternatives to force women into the program.

    Of course, women using the Delphi Screener may have worked out the significance of your HPV status: HPV- and you’re not at risk of cc, but more than that…HPV- and no longer sexually active or confidently monogamous…you might choose to forget about testing.

    Our program has (IMO) knowingly and seriously over-screened women for decades and over-treated HUGE numbers, many left worse off…there was always a better way, but they chose to continue to put women through pointless and excessive testing that did nothing but fill up day procedure.
    It tells me they don’t give a damn about women and our health and well-being, I wouldn’t trust them for a second. I know someone heading for Singapore to use the Delphi Screener, there are some cheap airfares at the moment, so she decided to take a 5 day break and use the Screener while she was there…that way she can confidently tell them to shove their program. (she’s confident her status will be HPV-) Remember that about 95% of women aged 30 to 60 are HPV-…

    By the way, the self test HPV option here won’t be available for the “unscreened” until next year, they claim there’s a problem with the lab accreditation, who knows whether that’s right or not.

    • Kiwicelt says:

      I read that about the self test not being available yet. Maybe they are deliberately holding it back, wouldn’t surprise me.

    • Kiwicelt says:

      The other thing that enraged me was the fact that if you are” eligible” for a self test, you have to do it under supervision at the GP surgery. Total control! I would just march right out taking my self test with me if I were going to screen.

  6. Why are they so against self testing?
    I think a few reasons: deeply entrenched paternalistic attitudes in the medical profession, a lack of respect for women, our dignity, bodily privacy and comfort.
    This program has ignored ethical and legal requirements for consent and informed consent from the very start.
    It also comes down to medical profits, they want women going into the consult room on a regular basis. Also, the perceived need to control women combined with the accepted fact that women can’t be trusted with their own health.
    Doctors have used the Pill, HRT and pre-natal care to force women into Pap testing, it’s all about entrapment, there was never anything elective about this program.
    This program doesn’t care about women, they’re happy to force women into regular and invasive testing when they know almost all can’t benefit but can certainly be harmed, they persist with the speculum exam in older women knowing most would be HPV- and knowing it will cause pain, bleeding, bruising/soreness and may even cause a UTI. They do Pap testing on pregnant women, seeing an opportunity to catch these women, but knowing the test is even more unreliable during pregnancy and that testing will often lead to months of worry about a false positive result and the possibility of a referral for an excess colposcopy. It’s cruel…
    We test young women knowing it doesn’t help but leads to lots of excess biopsies and over-treatment, we’ll continue to worry and harm our young women under the new program, we’ll start hpv testing at 25 even though the evidence clearly says…do not test before age 30.
    It says to me vested interests want these young women…to do pointless testing and for all the lucrative follow up.
    We had an opportunity to adopt an evidence based program, one that freely offered hpv self testing, it would have produced results, saved more lives with far fewer women being harmed but no….vested interests won again.

    • Kiwicelt says:

      You are so right Elizabeth. I agree that screening women in pregnancy is cruel. Imagine being pregnant and thinking you are at risk of Ca cervix, as many will. The health professionals know that even if you have ‘HSIL’ it will not be treated It is a pointless exercise. Hopefully some Doctors and LMCs will put the woman first. In our new programne they are considering offering vaginal oestrogen to get that speculum into post menopausal women! No mention of a self HPV test.
      As I have declined all further screening, I haven’t visited my Doctor in nearly four years. When I hit 55 I will, apparently, be offered a blood test so that I can be cardiovascularly risk asessed I won’t be having that either nor will I allow my weight to be taken or my blood pressure( I monitor that myself). From now on I take total charge of my health care.I will inform my Doctor when I am in need of his help.

  7. diane says:

    I met a woman at at a arty then other night. I mentioned I go to holistic Dr. and I am Dr Phobic. She started questioning me about screenings. ( what nerve) . She would nor acknowledge the fact that I am phobic. Just went on how it would save my life. I just said I choose not to screen.
    Why other women so insensitive , to women who have Dr Phobia. I found women Gyn even worse tan the men.
    I am so happy I finally gave tying to get help foe my issue. ( vaginimous or whatever).
    Yrs of anxiety and abuse and no help!.

    I agree its all about vested interest. SICKING!
    Too bad if Drs don’t respect my right not to screen!

  8. Elizabeth (Aust) says:

    https://theconversation.com/never-had-a-pap-smear-now-theres-a-diy-option-for-you-70706
    Some interesting comments…
    Again, no mention that some women choose not to screen, and that’s fine, it’s all about getting every woman screened who falls into the target population. There’s some discussion about HPV self testing, looks like it will now be offered to women more than 2 years “overdue”…but the sample must be collected at the GPs surgery, they’re using a general swab – the comment is made it’s almost as good as a test taken by a GP – so you can imagine the Delphi Screener is going to be just as good.
    Of course, the whole program and official discourse drip of disrespect and the need to control women…and part of that is blocking access to things like the Delphi Screener.

    • Mint says:

      “A doctor or nurse will tell you how to collect your own sample, which you can do in private if it makes you feel more comfortable”

      Of course you would want to collect your sample in private! The idea that a doctor or nurse would watch you as you collect the sample brings this process to a whole new level of creepiness.

  9. Elizabeth (Aust) says:

    https://www.tga.gov.au/advert-exempt/advertising-exemption-delphi-bioscience-australasia-delphi-screener-d200
    “Approval under section 42DF for use of restricted representations by Delphi Bioscience Australasia”
    The approval expired on 1/5/2017 so this is probably why the Delphi Screener seems to have vanished here…it was a restricted approval anyway, but now the precious new program is about to start…that’s the end of the Delphi Screener for Aussie women. (unless you fly to Singapore)
    I’ve sent an email to the Singapore office to see if they’ll post out the kit and allow women to return it for checking, I’m sure the answer will be no, unless you go through an Aussie GP.

    If we were serious about reducing the already low incidence of cc, we’d make it easy for women to test, allow them to buy the Screener and then give them sound advice, whether they’re HPV- or HPV+

  10. Kiwicelt says:

    http://dailym.ai/2B0qFav
    Off topic I know but there is an article about 3D tomosynthesis in the Daily Mail. If you have time to comment it would be great.

  11. katrehman says:

    Hi kiwi…done! I’ve posted a couple and will keep an eye out x

Speak your mind

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s