An Australian change.org online petition has found that over 70,000 people are concerned about the country’s latest changes to cervical cancer screening, to begin in December 2017. However, their comments also reveal a series of misconceptions about the program and about cervical cancer.
Currently, women in Australia ages 18 to 69 receive Pap tests every two years for cervical cancer screening, but under the new cervical cancer screening program that starts in December, women ages 25 to 74 will instead take a human papillomavirus (HPV) test every five years.
Screening for HPV every five years might save lives, and the new Australian program was designed to convince more women to start getting screened regularly. According to a study published in The Lancet, the new health screening program is estimated to improve cervical cancer detection rates by 15 percent.
But why did the online petition show that there are so many misconceptions and questions about the new cervical cancer screening program? Here are the top five misconceptions discussed by Terri Foran (the author of a dedicated news story):
Myth 1: The new program ends invasive examinations
Unfortunately not, Foran says. For most women, the procedure remains unchanged.
It’s only at the pathology lab that the process really changes. Instead of having the specimen being smeared on a slide (Pap smears), two brushes are used to collect cells from both the outside and the inside of the uterus. The brushes are then swizzled around in a preservative liquid to separate any HPV that might be present.
One other novelty is that cell collection can now be done by women themselves. A study estimated that even if a women had only one self-collected test at age 30, she reduced her risk of cervical cancer by 40 percent.
Myth 2: The new program could miss out on cervical cancers that are not related to HPV
According to the World Health Organization (WHO), almost 85 percent of cervical cancers are actually skin cancers caused by HPV. This type of cancer usually takes up to two decades to develop. Therefore, HPV testing may help detect potential problems long before a Pap test could identify malignant cells.
The remaining 15 percent of cervical cancers start in glandular cells and cannot be detected with the tools used for Pap tests. Usually, when women are diagnosed with cervical cancer after a normal Pap test, it is of a glandular type. The new program includes HPV testing that should detect this kind of cancer earlier and more reliably.
Some rarer types of cervical cancers (less than 1 percent) that develop from muscle, nerve, or pigment cells are not related to HPV infection. These cancers are not tackled in the new program; however, regular Pap tests were not equipped to detect them, either.
Myth 3: The new program doesn’t protect women under 25
Although some women have had cervical cancer before age 25, this age group is rarely affected by cervical cancer – about 1.7 in 100,000 women younger than 25 in Australia – and in the three decades of the current screening program, no significant impact was reported for women under 25.
In addition, younger women tend to have worse-looking cellular changes if there is a robust immune reaction to an HPV infection, which can lead to over-treatment of changes that would heal better left alone, suggesting that tests for those under 25 could be more harmful than beneficial.
Myth 4: Less screening reduces the chances of other cancer diagnoses, like cancer of the ovaries or of the uterus
Pap tests can detect precancerous changes in the cells of the cervix; however, they do not pick up endometriosis, polyps, or sexually transmitted infections that are not related to HPV infections.
It is important to keep in mind that screening is only for women without any symptoms. If any symptoms develop (like bleeding, pain, or abnormal vaginal discharge) a women is always advised to schedule a visit to her doctor, regardless of the date of her last test.
Myth 5: The new program is a cheaper option and shifts the costs to the women themselves
The new tests are more expensive than traditional Pap tests, but that is because of their enhanced sensitivity. They will still be funded by Medicare just like the Pap test is now, and any out-of-pocket costs depend on the healthcare provider’s charging policy.