What is a CST?
Cervical screening test (also known as CST ) now replaces the Pap smear test (as of 1st of December, 2017). The combined screening test is now the national standardised test across Australia. This is a critical screening tool for cervical cancer.
Previously, a Pap smear test would look at cell changes. The CST now checks for the presence of HPV (human papillomavirus) via DNA. Testing of DNA detects whether there is a presence of oncogenic HPV types*. The abnormal HPV groups have a higher chance of developing into cervical abnormality, including cervical cancer.
Who is the combined screening test for?
Women between the ages of 25 - 74, women who have been sexually active or if you are a woman or you are a person with a cervix.
How is it done?
After a consultation and an updated medical history is taken, you will be asked to change into a gown in the treatment room, removing clothing from the waist down and sit onto an examination bed. A sheet will be provided until you are ready for the test. Once you are ready, the doctor will come back in. Laying down, you will need to separate your legs to allow for the a speculum to be inserted the vagina. The doctor will insert something similar to a long cotton bud with a tiny brush on the end. This brush once inserted will gently be rotated to collect enough cells near the top of the cervix (ectocervix). It can feel quite uncomfortable for some, and others feel no discomfort at all. If it does hurt, tell the doctor straight away. It only takes a minute, and then once the sample is taken, you can get dressed and the doctor will prepare your sample into a liquid based specimen jar. That’s it - Hopefully for another 5 years!
At your consult where your sample is collected, you and the doctor can discuss how to get your results, which usually take about 2 weeks to come back from the laboratory.
If your result is normal:
The next CST test will be in 5 years. We will add you to our recall system and the National Screening Program will also be in touch with you in 5 years time.
If your result is abnormal:
HPV with oncogenic effect has been detected on your CST sample. Dr Leong or his nurse will be in touch with you to discuss the result. You will need further investigation and this is usually done in a follow up appointment. Dr Leong will perform a more advanced examination under a Colposcope (Colposcopy) to assess the cervix. A sample is usually taken again at this appointment along with a biopsy of cervical tissue.
During your school years (around 12 years of age), you would likely be immunised through Australia's National Immunisation Program. Vaccines currently used as Gardasil 9 and Ceravix. These HPV vaccines protects against 9 HPV types. Around 70% of these 9 HPV types are the ones responsible for cervical cancer. Since 2013, males have also been included in the program.
In 2021, it is estimated that a female has a 1 in 663 (or 0.15%) risk of dying from cervical cancer by the age of 85 in Australia.
The vaccine also helps prevent some HPV related cancers and diseases that affect males.
For further information on this program, please click https://www.cancer.org.au/what-is-hpv
If you are due for a CST or would like to check with our nurse about your CST history, please be in touch with our rooms on (03) 9428 7572.
*Oncogenic HPV types reported are HPV 16, HPV 18 and HPV (not 16/18). HPV (not 16/18) variants tested: 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68.