Cervical screening: understanding test results English - Rainbow - HE1193

You’ve taken the first step towards protecting yourself from cervical cancer by having cervical screening.

Regular screening is important to make sure you stay healthy for yourself and your whānau.

Screening tests look first for human papillomavirus (HPV) that causes most cervical cancers. If the virus is found, further tests are done to check for any cell changes.

This information will help you understand your cervical screening test results.

If any follow-up tests are needed, these will be free under the National Cervical Screening Programme (NCSP).

Ma te mōhio e piki ai te hauora me te waiora. Knowledge improves health and wellbeing.

What the results will show

Screening tests first show whether you have HPV. These results are usually available within 1-2 weeks.

Around 90% of people screened will NOT have HPV found and can just continue to have regular screening. This will usually be 5-yearly (or 3-yearly if immune deficient).

About 10% of people screened will have HPV found. This does NOT mean you have cancer. It may mean there is a risk of already having or developing precancerous cell changes on your cervix, so further checks are important.

The next steps will depend on what type of HPV is found. These follow-up tests check for any cell changes on your cervix.

HPV and cervical cancer

There are many types of HPV, which is spread by intimate skin-to-skin contact or any sexual activity.

80% of adults will have HPV at some time in their lives. Most types are not of concern and the body usually clears the virus by itself. However, some types can persist and cause cell changes that may lead to cancer.

Cervical cancer usually takes many years to develop. Regular cervical screening can identify people who are most at risk and treat any cell changes to stop them turning into cancer.

Understanding HPV test results

Depending on what is found in your sample, you can get a variety of different results from the laboratory. Here’s a guide to what each means.

HPV not detected

If HPV isn’t found in your sample, you won’t need to have another screening test for 5 years (or 3 years if you are immune deficient). This will be the case for most people.

HPV 16 or HPV 18

There are many different types of HPV. Some strains are more likely to persist and may lead to cervical cancer. If HPV types 16 or 18 are found (the 2 highest-risk types) you’ll be referred for colposcopy to check for cell changes.

This examination is done by a specialist colposcopist, who uses a microscope to magnify
and sometimes take samples from your cervix. Most people who have HPV 16 or 18 will NOT have any cell changes, but it is important to check.

HPV Other (type/number may be stated)

If one of the ‘Other’ types of HPV is found, and your test was done as a vaginal swab, you will be asked to go back to your healthcare provider to have a cervical sample taken (previously known as a smear test). This will be sent to the laboratory and tested for any cell changes (cytology).

If you chose to have a cervical sample taken (rather than a swab test) you won’t need to come back for this second appointment. The sample will be used to check for cell changes.

Depending on what type of cell changes are found you may then be referred for colposcopy.

Invalid or unsuitable for analysis

Very occasionally an HPV swab sample won’t be able to be used for testing. You will be told if your test is unusable, so you can repeat it.

If the result is reported as unsuitable for analysis, this will most likely be because the sample has leaked. Please ensure the lid of your sample is put on tightly.

How accurate are the HPV results?

The HPV test is very sensitive and accurate at detecting the virus. The test is just as good,
whether you do it yourself, get your healthcare provider to help, or have a cervical cell sample taken.

However, no test is perfect and there is a very small chance that HPV or cell changes could be missed. That’s why it is so important to have regular screening.

Cell changes on the cervix happen slowly over time. Regular screening is important so that changes can be picked up if they were missed the first time, or have developed since your last test.

Of the 180 people who get cervical cancer in Aotearoa New Zealand every year, 85% have either never been screened or have not had regular screening.

Understanding cytology test results

Cytology screening (looking at cells under a microscope) looks for changes in the cells on the surface of the cervix. If you have a cervical cell sample taken and a cytology result is reported as well as HPV, the results are more complex.

The cytology results that may be reported are:

Normal cytology results (a negative result)

No cell changes were detected. Future follow-up will depend on your screening history.

Unsatisfactory cytology results

Unsatisfactory results mean that the test could not be read at the laboratory because there were not enough cells in the sample, or blood or mucus hid most of the cells. You will need to have another test within three months.

Inflammation or infection

Occasionally your test result may show that inflammation or infection is present.

Discuss this result with your healthcare provider. Often no treatment is required.

Atypical changes

This means it is difficult to be sure whether cell changes are starting to develop. Mild atypical changes (called ASC-US or atypical squamous cells of undetermined significance) often clear up before your next test.

Mild (low-grade) changes (LSIL)

This means the cells are beginning to show some mild changes. LSIL (or low-grade squamous intraepithelial lesions) are due to an HPV infection.

These usually clear up on their own, so your next screening test may be normal. If it’s not, you may be referred for colposcopy. This will depend on your age and how many times HPV has been detected in your screens. Your healthcare provider will discuss this with you and confirm if you need to have another screening test in 1 year, or be referred to a specialist.

Moderate to severe (high-grade) changes (HSIL)

High-grade changes are cell changes that are more developed. They’re called high-grade
squamous intraepithelial lesions (HSIL). This doesn’t mean cancer (most people will have cell changes that can be successfully treated), but you’ll need colposcopy to check.

Most cell changes are either LSIL or HSIL. Occasionally there are glandular cell changes,
which are also regarded as a high-grade change requiring further investigation.

You may be recommended for further tests or treatment following your cervical screening results. Your healthcare provider will explain why you need any follow-up procedures and what they will involve.

Follow-ups

Colposcopy

Colposcopy (kol-poss-kapee) is an examination of the cervix using a magnifying lens called a colposcope. The colposcope looks like a pair of binoculars on a stand. It magnifies your cervix and vagina so that any abnormal areas can be seen.

The examination may include taking a small sample of tissue (a biopsy). The biopsy takes only a couple of seconds and may be a bit uncomfortable.

The specialist will discuss the results of your colposcopy at the end of your appointment and contact you about any biopsy results within about 4 weeks.

Treatments

It may be recommended that you have treatment to remove any area of cell changes. The type of treatment will depend on the type of changes and where they are on your cervix.

Many cell changes can be treated under a local anaesthetic during colposcopy. Your specialist will discuss the options with you. They will also be able to explain the various types of treatments.

Early treatment of cell changes is almost always successful in preventing cancer.

What happens to my health information?

Test results are recorded on a computer system, called the NCSP-Register, which is managed by Te Whatu Ora – Health New Zealand.

This helps ensure important information is available to you and your healthcare providers, and to manage your progress through the Programme.

It also:

• sends out recalls and reminders
• supports you if you need support accessing cervical screening services
• provides information to enable evaluation and review of the Programme
• enables research, approved by an ethics committee
• helps with planning for national and regional services.

No reports or research produced will identify any individual.

You can look at the Privacy section on the Time to Screen website for full details about how information collected by the Programme is securely managed.

You have a right to request your health information at any time by freephoning 0800 729 729 or emailing info@ncspregister.health.nz and verifying your identity (full name, date of birth, NHI, address).

Withdrawing from the programme

You can choose to withdraw from the NCSP at any time, or you can remain on the Register but opt out of receiving any communications. You can contact the Programme about either of these options and if you decide to withdraw, we will send you a form to complete. You can also find the form on our website. We will keep some of your identity details in our system with a note not to contact you again. All information about your cervical screening tests and history will be removed from our records.

You can re-join the Programme any time if you change your mind.

You need to be on the NCSP-Register to get an invitation, recalls and reminders to screen. If you are not sure if you are on the Register, call 0800 729 729 to check.

An important message

Cervical screening is for people who are well. If you’re having any symptoms, it’s important to see your healthcare provider without delay.

Symptoms could include:

• bleeding or spotting between periods or after your periods have stopped (after menopause)
• pain during sex or bleeding or spotting after sex
  
• persistent pain in your pelvis or lower back
  
• unusual discharge from the vagina/genitals.
  

These symptoms can happen for many reasons and rarely mean you have cervical cancer. However, it’s important to get them checked.

More information

If you need further information about the benefits of cervical screening and your options, and where to get screened, you can usually find the answers on our website TimeToCervicalScreen.nz

You can look at the privacy section on the Time to Screen website for full details about how information collected by the Programme is securely managed.

You can also contact:

• the National Cervical Screening Programme, freephone 0800 729 729
• your doctor or practice nurse
• Māori, Pacific and community health centres
• your local Family Planning clinic
• your local Cancer Society.

You can view this brochure and other health education resources at HealthEd.govt.nz