Previous pap smear testing which was based on looking for abnormal cervical cells derived by smear test taken intravaginally has been replaced with routine HPV ( human papilloma virus ) screening combined with liquid based screening of cervical cells derived by intravaginal brush sampling where indicated.
Routine testing is recommended from age 25-74 at 5 yearly intervals if there is no indication for more frequent testing such as a previous abnormality or recall.
The screening is now based on testing for the presence of high risk HPV viral types which has been researched to be a more sensitive test. If the virus is detected cytology screening is then done on the cells from the cervix that have been obtained at the same time from the same sample- looking for abnormal cells.
Results are in 3 categories
Low risk – HPV test is negative repeat in 5 years
Intermediate risk -HPV test is positive repeat test in 12 months
High Risk – HPV test is +ve for high risk oncogene HPV types and/or cytology is abnormal suggesting the presence of high grade cervical changes – follow up cytology by a gynaecologist is recommended
Testing can now be more focused by requesting the cervical screening test .
In the format of
Cervical screening Routine
Cervical screening – co test symptomatic
Cervical screening – follow up of previous abnormality
Cervical screening – co test Test of cure ( after previous treatment)
Cervical screening – previous AIS ( previous carcinoma in situ )