The new five-yearly Cervical Screening Test detects infection with Human papillomavirus (HPV) and replaces the two-yearly Pap test. If HPV is detected, the laboratory will automatically conduct a reflex liquid-based cytology (LBC) test on the same sample to determine if cellular abnormalities are present.
If both tests are performed, the pathology report will include the combined result as a risk category (low, intermediate and higher) with recommended clinical management. If any glandular abnormalities are detected, follow up in accordance with the 2016 Guidelines is required. Patients who have signs or symptoms suggestive of cervical disease are tested and managed through a different clinical pathway.
Early changes in cervical cells rarely cause symptoms. If early cell changes progress, the most common signs include:
- Vaginal bleeding between periods
- Menstrual bleeding that is longer or heavier than usual
- Bleeding after intercourse
- Pain during intercourse
- Unusual vaginal discharge
- Vaginal bleeding after menopause
- Excessive tiredness
- Leg pain or swelling
- Low back pain
Patients at any age who have signs or symptoms are recommended to have a co-test (HPV and LBC). Consider referral for the appropriate investigations to exclude genital tract malignancy.