Cervical Screening

Cervical cancer is cancer of the cervix, which is the lower part of the uterus or womb.  Cervical cancer develops slowly over time, usually taking many years, when abnormal cells grow on the cervix. These abnormal cells are caused by infection with high-risk types of HPV.  Abnormalities in the cells of the cervix can be detected by cervical screening and removed. Each year there are around 25,000 abnormal smear test results among New Zealand women.

Symptoms of cervical cancer

The symptoms of cervical cancer can include:

  • bleeding after the menopause
  • bleeding between periods
  • heavier periods than normal
  • abnormal vaginal discharge
  • painful sex, or bleeding after sex

If you have any of these symptoms see your doctor.

Cervical Screening

Screening remains the single most effective intervention against cervical cancer. Cervical screening has had a dramatic impact on the incidence of cervical cancer and cervical cancer mortality in developed countries including New Zealand.All women are eligible for screening in New Zealand, this includes:

  • Women who have never been sexually active
  • Women who have sex with women
  • Women who have not been sexually active for many years
  • Women who have had a hysterectomy but still have a cervix

Women aged 70 and over who have never had a cervical smear test are advised to have a smear test followed by another a year later. If both tests are normal no further tests are needed. Cervical smears are available from general practitioners or nurses, marae-based or other Māori health centres, Pacific and women’s health centres, and Family Planning clinics. The cost of a smear test is similar to the cost of seeing a doctor or nurse. Some community organisations offer a free or low-cost service. While recent studies indicate the rate of screening among Māori women have increased Māori, Pacific, migrant and young women continue to have lower rates of screening and Māori have consistently higher rates of cervical cancer. Rates amongst Asian women are particularly low particularly amongst mainland Chinese women and international research indicates rates of cervical cancer amongst these women are high.

HPV and Gardasil

Human papilloma virus (HPV) causes most but not all, cervical cancers.  Of the over 100 types of HPV, 70 per cent of cervical cancer is caused by just two strains (HPV types 16 and 18). A vaccine  (Gardasil) targeting some of these strains is approved for use in New Zealand and could potentially contribute significantly to the fight against cervical cancer. Aotearoa New Zealand has a school-based phase of the HPV immunisation programme providing Gardasil vaccine for girls from 12 years old.  Given the debate on the failure of informed consent processes with the MeNZB immunisation programme, and a troubling start to the national HPV immunization programme WHA raised concerns about some of the ethical issues surrounding mass immunization programmes targeting children and young people and argues that the principles of informed choice and consent must not be compromised by population health objective LINK. FEB 2009 WHU article.

Useful links

National Screening Unit »National Cancer Institute »