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Cervical test to go viral

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The dreaded biennial Pap smear could be dumped and replaced with a more effective five-year cancer screen test if the Federal Government adopts the recommendations of an expert advisory panel.

In a move that could increase the extent of cervical cancer screening and save more lives, the Medical Services Advisory Committee (MSAC) has proposed that the current two-year Pap smear test be replaced with a similar procedure that only has to be carried out every five years.

But relief for women could still be some time off, with the Federal Government warning the change was unlikely to be implemented before 2016.

The proposal has come amid evidence that less than 60 per cent of women targeted under the National Cervical Cancer Screening Program have Pap smear tests.

The Cervical screening in Australia 2011-12 report from the Australian Institute of Health and Welfare found that around 58 per cent of women aged 20 to 69 years participated in the screening program between 2009 and 2012, equivalent to more than 3.7 million people in a two-year period.

The Institute found participation was uneven, with those who were wealthier or living in cities significantly more likely to have a regular Pap smear than those less well off or living in remote areas.

But, even though only six out of 10 women in the target group participate, the figures suggest the screening program has saved many lives.

The Institute found that, in the 10 years following the introduction of the screening program in 1991, the incidence and fatality rate of cervical cancer halved, and have since held steady at around nine new cases per 100,000 women diagnosed each year, and two deaths per 100,000.

“In 2012, for every 1000 women screened, eight had a high grade abnormality detected, providing an opportunity for treatment before possible progression to cancer,” the Institute said.

According to evidence presented to MSAC, the new five-year test will be even more effective.

While the procedure is the same as that used to collect a Pap smear, the sample of cells collected will be tested for the human papillomavirus (HPV), “which we now know to be the first step in developing cervical cancer,” the Federal Health Department said.

 “MSAC found that a HPV test every five years is even more effective than, and just as safe as, screening with a Pap test every two years,” the Department said. “MSAC also determined that a HPV test every five years can save more lives and women will need fewer tests than in the current two yearly Pap test program.”

While millions of women and girls have been and are being vaccinated against HPV, the Health Department advised they would still require cervical screening because the vaccine did not protect against all forms of the HPV that cause cervical cancer.

Not only will the HPV be less frequent, women can also commence it later in life.

Current advice is that women undergo regular Pap smears between 20 and 69 years of age, but MSAC recommends that the HPV test not commence until a woman turn 25 years, with a final test to be conducted between 70 and 74 years.

The Federal Government said the MSAC reommendation “will now be considered after extensive consultation with State and Territory health authorities, medical and pathology experts and community stakeholders,” adding that “it is anticipated that changes will not be implemented prior to 2016”.

Adrian Rollins