By Jenna Price
A pap smear saved my life. It could save yours too, even if you've been vaccinated against HPV.
In 2007, I was standing on the sidelines watching my son play soccer. I was just chatting away to another woman who I knew, moving from the trivial to the deeply personal in a matter of moments.
Dr Ignatius Kung analyses pap smears at the Mayne Lab Cytology in Heidelberg.Credit: Eamon Gallagher
I mentioned the results of my pap smear – after explaining just how much I hated having pap smears. Something about her response unsettled me, she straightened her spine, her ears pricked up. Turns out she was full medical bottle on pap smears.
Anyhow, within a day I was having a biopsy and within a week, I'd had a hysterectomy. Terrifying.
Lucky. Also careful. I'm the kind of person who has her mammograms, pap smears and blood tests regularly.
About half of eligible Australian women are not up to date with their pap smears. Yep, not surprising. Lying on your back, having a probing widget trying to scrape some cells from your cervix is not fun. And if your pelvic floor is not in tiptop shape, it can be even more uncomfortable (now, maybe my darling Dr Pandora makes this up so I don't turn into one of those old women who leaks all the time, but it works for me).
Yep, half of you. Joe Tooma, the CEO of the Australian Cervical Cancer Foundation, reckons it is so low because women under 30 think they are protected against cervical cancer because they have had the human papilloma virus (HPV) vaccine.
Public service announcement for the people of Australia coming up right now.
Yes, it's true, Gardasil works well. But it's not perfect. This HPV vaccine works to stop the spread of two particular strains of HPV, numbers 16 and 18. Those two strains account for only 70 per cent of all the cancer-causing HPV viruses running rampant in our population.
So, until we have vaccines for the lot, you need to have a pap smear. At least until May next year. But getting checked won't stop there.
What's important about May 2017?
The whole pap smear thing is being revolutionised and replaced by an HPV test. It's still an internal vaginal exam, you will still get some probe setting out to explore what you have sitting on your cervix, but it won't be the same full pap smear you've had in the past.
Instead, if you have a positive result, the laboratory looks at the cells in the sample and then you may go on to a colposcopy (more internal tests and someone having a good long look at how your cervix actually appears). That will be like an extended pap smear.
Those of you in the all clear will be asked to have one of those HPV tests in five years.
And wouldn't that be awesome if it meant you were actually in the all clear for five years?
But we don't have the same kind of sex lives we had 30 years ago. Women don't even have the same experience of sex they had 10 years ago. In the second Australian Study of Health and Relationships, published two years ago, there was clear uptick in the percentage of women who have had multiple partners in their lives. About 40 per cent of heterosexual women have had somewhere between three and nine partners in the course of their lives. A further 20 per cent have had more than 10 and fewer than 49 partners over the course of their lives. Only 20 per cent of women surveyed said they had had sex with only one person over the course of their lives.
So it's quite clear that the majority of women don't stick with the same partner over the course of their lives and that's where the HPV virus can make trouble. One partner can be a glorious clean slate but who knows about the other half-dozen.
So, if we change partners, if we experience weird bleeding, if we have a little panic, can we still get a pap smear on Medicare?
Looks like the answer will be yes. It won't be one of those item numbers where you can only get it over a particular time period.
And we need to make sure it stays that way because this government can be a little deceptive on the whole Medicare thing. They keep shouting Mediscare but the real truth is, Australians are Mediscarred. And making sure this item remains on the unrestricted list is imperative.
In the meantime, make sure the young men and women who you look after are up to date with their HPV vaccines. Sexual health is not just a woman's responsibility. And it took a few years for boys to get on the schedule for this life-saving vaccine.
In 2006, a number of women I know paid $400 to ensure their sons were vaccinated with Gardasil. It was a huge cost but it made sense to ensure that the virus was stopped wherever it could be (and of course, gay men benefit too because HPV causes anal cancer).
At a national level in 2015, 77 per cent of girls who turned 15 last year had all three doses of HPV vaccine. Which is good but not perfect. Boys are lagging at just over 66 per cent.
And sadly, we can't say to prospective partners that it's no jab, no sex play.
The rate of HPV cancers is declining because of herd immunity. That's the good news. The bad news is that some of us will die because we never got ourselves tested.
Book your pap smear. Book your teenagers into their HPV immunisation and make sure they get the lot.
Do it today.
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