how to guide
Your guide to cervical screening
A step-by-step of what you can expect from the test.
Find out about “self-collection” and if you might be eligible.
Lots of people in our communities find cervical screening difficult, uncomfortable or even impossible. Here are some tips to help you get through the test.
What happens during a Cervical Screening Test?
A Cervical Screening Test involves the collection of cells during an internal exam, which typically takes a couple of minutes.
The procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap test. You will undress from the waist down and lie on your back on an exam table with your knees bent. You can sit up a little if that is more comfortable for you.
Your healthcare provider will insert a speculum and use a small brush to take a sample of cells from the cervix. You can also insert the speculum yourself, which can make it a lot easier if you’re uncomfortable with the test.
The sample of cells will go to a lab and be tested for HPV. If you test positive for HPV, the same sample will then be tested for abnormal cell changes. If anything is detected, your doctor will advise you about the next steps.
Can I do the test myself?
Self-collection – when you collect your own sample using a swab (so no speculum!) – is only available under Medicare if you’re over 30 and have never had cervical screening, or you are overdue by 2 years or more (so it's been 4 or more years since your last Pap test).
If you're eligible for self-collection and it's the best option for you, your doctor or nurse will give you a small swab and and tell you how to collect a sample from your vagina / front hole.
It’s a less effective screening test and if your sample tests positive for HPV, you’ll need to come back in so a clinician can take a sample of cells from your cervix to check for any abnormal changes.
It’s definitely better to get the full test in one go, but if you have found Paps difficult or impossible in the past and you’re now over 30 and overdue by 2 or more years, this could be a really good option for you. Talk to your GP or healthcare provider about self-collection options.
Getting through your Cervical Screening Test
Lots of people in our communities find cervical screening difficult, uncomfortable or even impossible. Getting screened is the very best way to protect yourself from cervical cancer and the new test means you only have to get it once every 5 years. Here are some tips to help you get through the test:
Find a doctor or clinician you can trust
Ask your friends for recommendations! They're often the best source of knowledge for finding a doctor you can trust.
Family Planning NSW doctors and nurses are highly skilled and specialists in sexual health – and they have been through training with the Gender Centre. If you’re in Sydney, ACON runs a free, community-led clinic with Family Planning NSW that provides cervical screening and sexual health checks: Check OUT is open on Tuesday evenings in Surry Hills.
DOWNLOAD OUR LETTER TO YOUR DOCTOR
Sometimes speaking up in the doctor’s office and asking for what you need can be really hard. Thinking about it beforehand and having it in writing to hand over to the doctor before your test can make it a lot easier.
We have letters you can download and take to your doctor or healthcare provider. Our general letter confirms the changes to the cervical screening program and explains why you need a Cervical Screening Test. Our comprehensive letter covers identity, pronouns and requests for the testing procedure. You can select the options you need, like nominating a safe word, requesting a quiet space after the test, or inserting the speculum yourself.
TAKE A CO-PILOT
You are absolutely allowed to take a friend, a lover, a family member in with you. Having someone there who knows who you are and what you need can make all the difference. Talk to them beforehand and let them know what you might need. They can step in if you can’t speak up in the moment (which can happen when we’re anxious or nervous or feeling triggered).
A co-pilot is there to take over if you need it: “My friend finds these tests really hard. Can you make sure to only use this language to talk about their body?”
YOU’RE IN CONTROL
Think about what you might need to make this easier on yourself. Talk to friends about what they do. WRITE IT DOWN. It can be daunting to tell a doctor exactly what you need if you’re feeling anxious, so take in a list and give it to them. You are in control.
WHAT LANGUAGE WORKS FOR MY BODY?
There might be words you do not want to hear during your visit, or words to describe your anatomy that work for you. Tell your doctor, write it down, or take a friend (your co-pilot!) so they can back you up if you need it.
You might want gender-neutral language - like 'bits', 'genitals' or 'junk' - or you might need specific language that affirms your gender. You may be more comfortable with medical language. You have the right to ask for what you need.
WHAT DO I WANT FROM THE PERSON DOING THE TEST?
Maybe you find it easier if the doctor or nurse tells you every single detail of what they’re doing. Or maybe you need them to only tell you the basics and let you drift off. Maybe you want small talk or maybe you need some silence so you can go somewhere else in your head as much as possible. You might want a few minutes alone afterwards. All of these things you are allowed to ask for from your healthcare provider. Practise what you need to say, write it down, and/or take a co-pilot.
YOU CAN INSERT THE SPECULUM YOURSELF
You are absolutely allowed to do this. Inserting the speculum yourself can mean you feel much more in control of what’s happening.
"Self-insertion" means you insert the closed speculum yourself. Then the doctor or nurse can complete the test by opening the speculum and collecting a sample. Taking over the first part of the test yourself, even though the doctor has to do the rest, can make a huge difference.
YOU CAN SIT UP A LITTLE, RATHER THAN LYING DOWN FLAT
Lying down on your back can feel really vulnerable. Sitting up a little can definitely help if you’re nervous and staring at the ceiling is only making it worse. You can also ask your healthcare provider to stand slightly to the side of the exam bed.
You can nominate a ‘safe word’ and tell your doctor or nurse. Sometimes saying “Red!” (for example) is going to be a lot easier than explaining that you’re feeling really uncomfortable and need to stop.
YOU ARE ALLOWED TO TAKE MORE THAN ONE VISIT TO GET THIS DONE
Don’t be hard on yourself. You do not have to ‘succeed’ in your first attempt. If you need to have one visit to talk to the person who will give you the test and another one to get it done (or another five), then that is UP TO YOU.
You are allowed to not ‘finish’ the test and try again another day. Finding a a free or bulk billing practice (like Check OUT) will help give you the option to do return visits.
20 MINUTES FOR 5 YEARS’ PEACE OF MIND
Remember that if all goes well with this test, you won’t have to do it again for 5 years. You deserve healthcare. You can do this.
Follow up and results
NEGATIVE FOR HPV?
If you test negative for HPV, then you come back in 5 years for your next test.
SO, WHAT HAPPENS IF YOU TEST POSITIVE?
If you test positive for HPV, your cell sample (the same one taken at during your Cervical Screening Test) will undergo another test in the lab looking for abnormal cell changes. The combined results of these tests will determine a person’s risk of developing cervical cancer and what the next step is.
You might just need to come back in 12 months for a follow-up test, or you might need to get a colposcopy (specialist examination of your cervix, which sometimes involves a biopsy).
Remember, it usually takes a really long time for HPV to cause abnormal cell changes and then a really long time for those cell changes to become cancer.
If you get a positive result for HPV, the most likely thing that will happen is follow-up testing to make sure your body clears the infection on its own (which it usually does!)
Still want to learn more? Read on here for more information about HPV, sex and Cervical Cancer.