At the end of 2017, the Australian government implemented changes to the way doctors screen women for cell changes that can lead to cervical cancer.

In December 2017, the government dumped your biennial Pap smear and replaced it with a Cervical Screening Test, which you’re meant to have every five years if you’re a sexually active woman between the ages of 25 and 74.

The new test, a speculum exam just like a Pap where they scrape some cells from the opening of your cervix, looks for HPV, the virus which causes cervical cancer in over 99% of cases. The Paps of old didn’t look for HPV, but did look for precancerous changes to cells. This one does both.

I think I had a negative Pap test back in 2016 – or at worst, one where my cells had changed within a normal variant – before I moved to the UK for two years. So when I got back, I went to my doc in Surry Hills in Sydney to make sure all my private bits were still in tip top shape. I got the Cervical Screening Test and an STI Test at the same time, because hey, my doc was already up there.

When she called me back in earlier than my planned results appointment a week later, I was convinced she was going to tell me I had Chlamydia. When she told me to take a deep breath before she started to explain my results, I became even more certain.

Nope, I’m all clear there. The problem was with my CST. The test detected an abnormal growth of cells on my cervix, called a high grade squamous intraepithelial lesion, which is caused by HPV.

The test could also narrow down that I did not have the real grisly strains of HPV, 16 or 18, the two which significantly increase your chances of cervical cancer (and no, that doesn’t mean I have genital warts or herpes).

That makes sense considering I was one of the first year’s worth of young women to cop a free needle as part of the National NPV Vaccination Program back in 2007, protecting me against the scary types 16 and 18, and types 6 and 11, which cause 90% of genital warts. It’s worth noting that boys only started getting the jab in 2013.

From 2018, they changed the HPV vaccine from Gardasil to Gardasil9, and it’s all in the name, really: the new vaccine protects against the above four, plus the five next common HPV types associated with cervical cancer. I might have one of those! Who knows!

Anyway, the reason I’m telling you all this is because I think it’s worth us all knowing what we’re in for if a doctor detects something amiss in your cervix. And I also want you to know it is totally normal to freak tf out when presented with the news that there might be something in your body that could be a sorta precursor to cancer.

After my appointment I convinced myself that I did have cancer (I don’t, it usually takes 10 years for cell abnormalities like mine to develop into cervical cancer), and called my mother and my best mate – who is a nurse and told me to quit catastrophising. They each offered to accompany me to my colposcopy appointment at the Chris O’Brien Lifehouse at RPA.

I’ve since asked my doctor to really slowly talk me through what it means to have ‘high grade’ abnormal cells, what exactly I’m in for at my appointment, and what happens next.

She told me that the cells on our cervix are constantly changing – dividing, active, the way skin cells are – depending on the stage of your cycle and a whole heap of other factors. So you could be tested when your cells are at their healthy normal baseline, or you might get caught at a moment of borderline or even low grade changes – in which case you just pop in for another Cervical Screening Test a year later:

The vast majority of borderline changes, if we re-check in about six to 12 months, go back to the baseline… Even the low grade changes, when repeated maybe six maybe 12 months later, generally would go back [to the baseline].

After borderline and low grade cell changes, you might end up with abnormal cells – like me! – which are called cervical intraepithelial neoplasia (CIN). They’re distinguished as low grade or high grade, or I, II or III, in terms of severity.

But, as my doc says, “people shouldn’t panic” if they’re found to have CIN III: “We’re still identifying [cell] changes, not necessarily that will go back to normal, they may possibly need treatment, but they ain’t [cancer] yet.”

The colposcopy I’m due to go in for will “assess more precisely” the level of change in my cells: they’ll use different dyes which will help my gyno to properly see just how bad the damage is. Medical vinegar will cause abnormal cells to turn white. And sometimes a second solution (Lugols iodine) will be used to stain normal cells black and abnormal cells yellow.

My doc assures me it wont hurt, that I wont be able to feel anything – it’ll be just like when they insert a speculum during a regular CST, except there’ll be a camera involved. “You’re sat there and you can watch it on a TV screen if you want… They look on the screen to see if there’s abnormal cells around [your cervix] which will take up the dye.”

They might even take a biopsy of an abnormal area. All in all it’ll help them to determine if I need treatment now, or if they’ll just be keeping at a close eye on my cervix, scheduling me in for regular appointments.

If they do decide I need treatment, one option is a diathermy – a technique where they use heat from electric currents to destroy unhealthy tissue – or they just might cut out the abnormal cells. And they might do it right there and then “if there’s a big patch” they reckon deserves immediate attention. After that, no sex, tampons or strenuous exercise (swimming, running, etc), maybe a weird discharge, but I should be right.

While the fact that they’ve only been testing for HPV since December 2017 means they can’t tell us how long we’ve been infected, my doc assures me that it’s like any other virus – for instance the flu – and “your immune system can actually push it out and get rid of it at some point”.

Still for now, until my CSTs come back negative for HPV two years running, I’ll have to be heading in for a Cervical Screening Test every 12 months.

In the meantime though, I’ve made an appointment for this colposcopy, and I’m going to be fine okay?

National Cervical Cancer Awareness Week runs from 16 to 22 November. If your last pap smear was two or more years ago, it’s time you went in for your very first Cervical Screening Test. Because at least then you’ll bloody know what’s going on up there. Learn everything you need to know about your lady parts HERE.

Image: iStock / Motortion