The way we check for cervical cancer has changed. Here's what you need to know. Photo/ Getty Images
The way we check for cervical cancer has changed. Here's what you need to know. Photo/ Getty Images
Around 180 people get diagnosed with cervical cancer in New Zealand every year
Roughly 85% of those people have either never been screened or have not had regular screening
Death caused by cervical cancer has decreased by more than 60% since the National Cervical Screening Programme was introduced in 1990
A new way of testing for cervical cancer was launched in New Zealand in September last year. Ten months later, experts weigh in on the screening update and why it’s the biggest “game-changer” in sexual health care.
Cervical screening has long had a dread attached to it, whether it be the often uncomfortable speculum exam or the fear of receiving news you don’t want to hear.
But now, a change in the way we check for cervical cancer is making the process easier, faster and less stressful - and is seeing a lot more people come through the doors.
HPV screening was introduced in September 2023 and is a less invasive way to check for cervical cancer.
Here’s what to expect when you are due for a cervical check-up and why there is no reason to put it off for any longer.
What is cervical screening?
Cervical screening is used to identify abnormal cells in the cervix that could potentially become cancerous.
Simply put, cervical screening is a term used to describe the multiple procedures that check for cervical cancer. These include smear tests and, now, HPV swabs.
Knowing when, where and why you need to check for cervical cancer is important, not only to keep on top of your health but to understand how your body works - and when something is wrong.
New Zealand’s cervical screening guidelines have seen an update recently, with the Ministry of Health changing the recommended check-up age from 21 to 25.
From then on, women aged 25 to 69 should get screened every five years, says Southland gynaecologist Dr Danielle Jones. However, she says various factors, such as past positive tests and abnormal smears, may affect this number.
Interestingly, pap smears are the only type of screening that “can actually prevent invasive cancer”. Photo / 123RF
Where is cervical screening available?
Cervical screening can be accessed through various channels and can be performed by:
A GP (general practitioner) at your local doctor’s office
Nurses at Sexual Wellbeing Aotearoa (formerly Family Planning)
A gynaecologist
Te Whatu Ora funds free cervical screening for people with a cervix who have never had a screening test. Māori and Pacific wāhine aged 25 to 69 and people with a Community Services Card also get free screening.
The price of HPV tests and smear tests will depend on clinic charges.
Early diagnosis of cervical cancer not only gives patients a better chance at a cure but can prevent it from forming altogether, says Sue Claridge from Auckland Women’s Health Council.
Interestingly, cervical screening is the only type of screening that “can actually prevent invasive cancer”, she says, by detecting changes in the cervix early. This is a big reason why sexual health and cervixes should be checked regularly.
How has the cervical screening process changed?
In the past, a pap smear - or Papanicolaou smear - was the only way to collect cells for testing, which would be done via a speculum exam. Now, a new format has been introduced which has changed the way we approach cervical screening.
Dr Jones adds: “The process has changed to HPV swabs because this is both more accessible, meaning people can do it in their home or with their GP, and less invasive.”
The change, says Dr Jones, has seen “a difference in the amount of people” coming through the doors.
Julie Avery, the director of nursing at Sexual Wellbeing Aotearoa, says the new test is a “game changer”.
Avery further stated that “the new HPV test is one of the most significant advances in sexual health care” she has seen in the 17 years that she’s been working in sexual and reproductive health.
Is HPV testing a “game changer”?
Since HPV screening was introduced in September last year, there has been a big shift in the sexual health sector - and the numbers prove it.
According to Te Whatu Ora’s director of primary and community care Alana Ewe-Snow, 310,000 people were cervically screened in the eight months between the introduction of the new HPV testing in September 2023 and the end of May this year.
Of those tested, 80.7% were screened with HPV swabs. 18.9% had never been screened before or hadn’t been screened in the last five years.
When looking at data between May 2023 (before the HPV test rollout) and May 2024 (after the HPV test rollout), coverage for Māori had increased from 57.5% to 60.1% in that year. Coverage for Pacific people had increased from 56.5% to 64.3%.
HPV stands for human papillomavirus and is said to be the most commonly spread sexually transmitted disease, according to the HPV Project.
HPV refers to a group of viruses of more than 150 strains that cause infection on the surface of the skin, sometimes resulting in warts. However, HPV can be present as an infection of the skin which is not visible to the naked eye, which means that many people with genital HPV do not know they have it.
The reason we test for HPV when doing cervical screening, says Avery, is because some strains, called high-risk HPV, can cause cervical cancer. If an HPV swab comes back positive, it means individuals have been diagnosed with a high-risk HPV strain. Medical professionals will then encourage a pap smear to check if the strain is cancerous.
Cervical cancer is the most common cancer caused by HPV, however, the virus can also cause head, neck and other cancers across the body, according to Health New Zealand.
There is an HPV vaccine, or nine-valent vaccine (HPV9), that protects individuals against HPV cancers. The vaccine we use in Aotearoa is Gardasil 9 and it is prescribed via an injection in your arm.
It is free for those aged 9 to 26. Children between the ages of 9 and 14 need two doses while those 15 and older need three doses.
While no treatment is available for HPV that is asymptomatic, the body’s immune system naturally clears most HPV cases within 1-2 years, according to the HPV project.
Megan Watts is a lifestyle multimedia journalist and has been working for the NZ Herald since 2022.
