Welcome to The Inner Circle, Can We’s conversation on cervical cancer
Did you know that LGBTQ people are less likely to screen for cervical cancer than the general population? Everybody with a cervix is at risk of cervical cancer. If you have a cervix, you need to screen. It’s that simple. 20 minutes every 5 years could save your life. Can We is here to help our communities stay healthy. Welcome to the Inner Circle.
Launched in 2017, ACON's cervical screening campaign, The Inner Circle, shifts the conversation around cervical cancer, encouraging all LGBTIQ+ people with a cervix to stay healthy by reaching out to our 'inner circle' on the importance of regular screening. The cervix happens to be an inner ‘circle’ too! The Inner Circle is now part of Can We, bringing these conversations together through a single platform. Here you’ll find everything you need to know about cervical screening, including HPV and the Cervical Screening Test, how to book your test and tips for getting through it. If you have any questions, Can We is here to answer them.
Can We talk about cervical cancer and screening?
what is cervical cancer?
Cervical cancer is cancer of the cervix, the lowest part of the uterus or womb. 99.7% of cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer develops slowly, taking an average of 10 years from an HPV infection. That’s why cervical screening is so important, and why testing for HPV is effective in detecting potential problems much earlier.
What is the Cervical Screening Test?
The Cervical Screening Test the new (since 2017) way we screen for cervical cancer. It’s for anyone with a cervix who has ever been sexually active—regardless of gender identity, sexuality or sexual history. Cervical cancer doesn’t discriminate. The test looks for HPV (human papillomavirus). If your test is positive, your sample is tested for any abnormal cell changes. Your doctor will advise you if anything is detected. If your test is negative, you come back in five years for your next one. It’s free and you’re eligible for your first test at 25 or two years after your last Pap test. Screening occurs until age 74.
How does the Cervical Screening Test differ from the Pap test?
2017 marked the launch of the new Cervical Screening Test which replaced the old Pap test. The new test detects the presence of an HPV infection, which causes 99.7% of cervical cancer, while the Pap test detected abnormal cell changes. These cell changes caused by HPV that can lead to cancer often take many years to develop, so looking for the presence of HPV detects potential problems much earlier making for a more effective test.
Check OUT Clinic is ACON’s very own LGBTIQ+ sexual health clinic in Sydney, run in partnership with Family Planning NSW. The clinic is open to all LGBTIQ+ people. Our expert staff will take care of your Cervical Screening Test and any other sexual health needs, and our LGBTIQ+ peers will help make your visit a comfortable one.
If you have a cervix, you’re at risk of cervical cancer
If you have a cervix and you’ve ever been sexually active you need to screen for cervical cancer. It doesn’t matter if you’re gay, lesbian, bisexual, trans or queer. If you’ve had the HPV vaccination or not. Whether you’ve only had one partner, or if you no longer have sex. If you’ve been through menopause, or don’t have penetrative sex. If you’ve had a partial hysterectomy. Even if you have a cervix, but a doctor tells you don’t need to screen. There’s so many myths out there and Can We is here to bust them. Every body with a cervix is at risk of cervical cancer. If you have a cervix and you’ve ever been sexually active, you need regular cervical screening from the age of 25.
What is the screening process?
The test collects a sample of cells during an internal exam, typically taking a few minutes. It’s a different test from the Pap test, but the same procedure—undressing from the waist down and lying on your back or sitting up a little with your knees bent on an exam table.
Your healthcare provider will insert a speculum and use a small brush to take the sample from the cervix. You can also insert the speculum yourself, which can make it a lot easier if you’re uncomfortable with the test.
The sample of cells will go to a lab and be tested for HPV. If you test positive for HPV, the same sample will then be tested for abnormal cell changes. If anything is detected, your doctor will advise you about the next steps.
If you test negative for HPV, then you come back in 5 years for your next test. Check out the video below to learn more.
What actually happens during a Cervical Screening Test?
Check out this video from The Inner Circle to learn what happens during a Cervical Screening Test.
Can I do the test myself?
Check out this video if you want to know more about self-collection.
I'm trans, do I need to screen?
Do trans men and trans masc folk with a cervix need cervical screening?
Yes. Trans men who have a cervix and are 25 years of age or older are at risk of cervical cancer and need regular cervical screening.
What if I’m on testosterone?
Being on testosterone doesn’t reduce your risk of developing cervical cancer. For some people on testosterone (and some post-menopausal people), hormonal changes to the front hole/vagina can make getting a good sample from the cervix difficult and uncomfortable. A prescription from your GP for topical oestrogen before your test can help make it more comfortable – it’s only temporary and rarely has side effects.
I’ve had a hysterectomy. Do I still need cervical screening?
If you’ve a partial hysterectomy, which preserves the cervix, you definitely need to continue cervical screening. If you’ve had a full hysterectomy (where your uterus was entirely removed), including the cervix, you don’t require cervical screening.
People who don’t have a cervix are still able to get a test that is similar to the Cervical Screening Test (in that it can test for the presence of HPV and look for any changes to the cells of the vagina/front hole). Talk to your doctor about whether you need to continue having the test, it will depend on your medical history before you had the hysterectomy.
My Medicare gender is ‘male’ and I have a cervix – will I be added to the Register?
If you’ve had a Pap or Cervical Screening Test at any point in your life, you will have been added to the Register automatically, even if your gender is male under Medicare.
The National Cancer Screening Register gets information from Medicare, so if you need to change your personal details, it has to be done through Medicare. You can call on 132 011, check your Medicare account here, or use your MyGov account to change your details.
If you have never had a Pap or a Cervical Screening Test, you have changed your Medicare gender to male, and you still have a cervix, you will not be automatically added to the National Register (the Register only automatically adds people whose gender is ‘female’ under Medicare). If you’re under 25, talk to your GP or healthcare provider about getting a reminder letter (some medical centres and GPs will do reminder letters for cervical screening). As soon as you’ve had your first test, you will be added to the Register and receive reminders. If you’re over 25, book your screen here.
Do trans women need to screen?
There isn’t a lot of research on trans women and cervical screening, but the risk of developing “cancer of the neo-vagina” (as it’s known in medical terminology) for trans women or other people who have had vaginoplasty is thought to be very low. The risk of cancer developing from HPV will depend on what type of surgery you have had as well as your personal health history (things like previous HPV infections, HIV or auto-immune conditions). Talk to your doctor about your personal risk factors. Visit TransHub to find a gender-affirming doctor.
What if I don’t have a cervix, should I get tested for HPV?
Some people have vaginas but don’t have a cervix. This can include some trans women, some trans men, some intersex people and people who’ve had full hysterectomies. They are able to get a test that is similar to the Cervical Screening Test (in that it can test for the presence of HPV and look for any changes to the cells of the vagina/front hole).
HPV testing for people who weren't born with a cervix isn’t usually covered by Medicare and isn’t part of a standard STI test. If you’re really worried, talk to your doctor about the pros and cons of HPV testing.
If you’ve had a full hysterectomy (meaning you used to have a cervix and don’t anymore), talk to your doctor about whether you need to continue to have the test – it will depend on your medical history before you had the hysterectomy.
Why is cervical screening so important for Aboriginal and Torres Strait Islander people?
Aboriginal people are 2.5x more likely to get cervical cancer than the rest of the population. While the Cervical Screening Test is effective for reducing the risk of cervical cancer, participation in cervical screening among Aboriginal and Torres Strait Islander people is low. It’s so important to get regular screening tests.