At-Home Pap Smears Are Coming in 2022, Saving Lives and Supporting Inclusivity

Do you always dread getting your pap smear? Same.

Even though it only comes around once every five years, it’s just one of those experiences that will never be pleasant. It feels invasive and can sometimes be super anxiety-inducing.

Well, it turns out that we might not have to go in for them anymore.

Sounds too good to be true! But it’s not!

Family Planning Victoria (FPV) is hoping that a new Federal Government initiative will take cervical screening (previously pap smear) off the ‘to-do’ list for millions of people, ultimately saving lives.

As of July 1 2022, all eligible Australians will be able to access a self-collected cervical screening test through a health care provider of their choice.

This means that we can literally just rock up to our GP or specialist and acquire an at-home test that we can do ourselves in the privacy and comfort of our homes.

This is a step towards inclusivity and flexibility that is truly refreshing and amazing to see, especially for the LGBTQIA+ community, as well as those with disabilities or who are struggling with mental health.

I think we can all agree that going in for these types of checkups can be stressful at best. For those in communities that lack representation, such as the trans community, going into clinics can be quite a traumatic experience. FPV Medical Director Dr Kathleen McNamee says this is a positive step forward for the sexual healthcare industry and for anyone with a cervix.

“This new healthcare technology will encourage and support eligible Australians from all walks of life to access the test; this includes those who may face barriers to traditional screening due to cultural practices, concerns about discomfort or pain, or members of the LGBTQIA+ community,” Dr Kathleen said.

“The tests are simple to do and are just as effective as the current test at detecting potentially worrying strains of Human papillomavirus (HPV).”

We caught up with Dr Kathleen to chat about this new at-home cervical screening offering from FPV, and what this means for underrepresented groups moving forward.

PS: What do you hope comes from this shift to self-collection cervical screenings?

Dr K: I’m hopeful that there will be an increased uptake of cervical screening with the new self-test measures, given people will be more comfortable performing the screening themselves rather than having a healthcare practitioner do it.

Given nurses currently have to complete a course to offer cervical screening as a service, the changes also mean more practitioners will be able to provide the self-collection tests.

PS: What is the most common reason people often avoid cervical screenings? 

Dr K: Generally, a cervical screening is avoided because people tend to feel embarrassed, they also think the process will be uncomfortable or painful. People also tend to avoid cervical screening due to time and cost constraints or even lack of access to a practitioner of a certain gender or one who possesses empathy.

Many also have distrust in the system but lack of education is also another big contributor. For example, some people tend to assume that if they have never had penetrative intercourse with a penis or if they have stopped having intercourse they aren’t at risk and therefore don’t need a cervical screening, but this isn’t the case. Some may also believe they would know instinctively if something was wrong, but symptoms of cervical cancer only occur at a late stage.

PS: How do you think this will positively change the accessibility for the LGBTQIA+ community to get tested?

Dr K: The LGBTQIA+ community has many barriers to healthcare, including being more likely to experience discrimination or stigma in their interactions with healthcare practitioners.

There is evidence that trans men with a cervix are under-screened. This may be because some don’t feel comfortable having a practitioner perform a vaginal examination.

Taking away the need for a healthcare practitioner to conduct the test will hopefully increase uptake in screening for many of the LGBTQIA+ community and remove barriers that can exclude people with a cervix from undergoing such an important test.

Cervical screening can be uncomfortable and awkward at the best of times so giving the option to all Australians with a cervix to conduct the test themselves is a huge step in the right direction when it comes to inclusive healthcare.

PS: Will this shift to self-collection benefit any other minorities, such as people with disabilities?

Dr K: It is hoped this shift to self-collection will increase uptake in all under-screened groups, which definitely includes those with disabilities. It’s likely it will directly benefit those with a physical disability that may make the process of an examination of the cervix difficult.

This transition to self-collection will ultimately hand the power to any Australian with a cervix to choose how their screening is done, ensuring their dignity is kept intact and that they feel safe and comfortable.

This will also be beneficial to those living in more remote communities such as Aboriginal and Torres Strait Islander people who aren’t able to frequently travel to a healthcare practitioner to have the screening done due to distance constraints. Instead, the screening test can be posted out after a telehealth consult. Whereas others who are closer to a healthcare practitioner will have a consultation and then be able to perform the screening themselves in a private section of the practice, such as the bathroom.

Another under-screened group are culturally and linguistically diverse people (CALD). We’re really hoping that uptake will increase once these changes are implemented and those who are culturally and linguistically diverse will have fewer barriers to accessing healthcare.

PS: Is the self-collection test easy? What does it entail step-by-step?

Dr K: The self-collection method is pretty simple and will include a long cotton swab stick that is inserted into the vagina, similar to how you would insert a tampon. There’ll also be instructions on how far to insert the swab, such as a marker.

You’ll then need to rotate the swab around the vagina for 10-30 seconds and then place it in a container. All in all, it’s not a super complicated process and will be a lot easier and more comfortable for many people with a cervix to perform themselves rather than having a healthcare practitioner do it.

PS: What do cervical screenings protect us from and why are they important?

Dr K: Cervical screenings protect us from cervical cancer by early detection and management of the virus responsible. Early treatment is straightforward and effective but worldwide cervical cancer is very common.

Here in Australia, we actually have one of the lowest rates of cervical cancer in the world. But with the implementation of this screening program in combination with the HPV vaccine, Australia may be able to eliminate cervical cancer altogether in the years to come.

PS: Will this be a nationwide thing, or just in Victoria?

Dr K: This is a nationwide program and will be rolled out across the country.