The National Cervical Screening Program

Everything you need to know about the changes

In December 2017, the National Cervical Screening Program will change. This page outlines how and why the program will change, and provides answers to common questions.

If you have questions which aren't answered here, call Family Planning NSW Talkline on 1300 658 886 or talk to your local health care professional.

Why is the program changing?

The National Cervical Screening Program started in 1991. It has been very successful and Australia now has one of the lowest rates of cervical cancer in the world.

New knowledge and technology means it is time for a change because we can find the cell changes that could lead to cervical cancer sooner.

We now:

  • know that cervical cancer is linked to some types of the human papilloma virus (HPV)
  • have a successful National HPV Vaccination Program for young girls and boys. This prevents infection with the types of HPV which are most commonly linked with 75% of cervical cancer (types 16 and 18)
  • have new testing technology for HPV infection which is more sensitive and accurate than the traditional Pap test. This helps to detect whether you are at risk of cervical cancer

How is the program changing?

The important changes from December 2017 are:

The Cervical Screening Test (cells from the cervix tested for HPV infection)... ...replaces the Pap test (cells from the cervix examined for physical changes)
The Cervical Screening Test is every 5 years ... ...instead of every 2 years
Women will be invited for a Cervical Screening Test from the age of 25 years ... ... instead of 18 years
Women will have their last Cervical Screening Test between 70 and 74 years of age ... ... instead of 69 years

How is the new Cervical Screening Test performed?

The experience of having a Cervical Screening Test is exactly the same as having a Pap test. You will still have an examination using a speculum so that the cervix can be seen properly to take the sample of cells for HPV testing. The sample is collected using a special brush which is then placed in a container of liquid and sent to the pathology laboratory for testing.

What happens if I have a positive test?

If your test is positive for any high risk types of HPV which could put you at future risk of cervical cancer the laboratory will automatically carry out a second test to look for changes in the cells of the cervix (liquid based cytology). This second test is also part of the Cervical Screening Test. You and the doctor or nurse who performed the Cervical Screening Test will be informed about the result with recommendations for next steps.

If your test is positive for either HPV types 16 or 18 you will be referred for an examination called a colposcopy (a closedexamination of the cervix under magnification). If any cell changes are found a biopsy can then be taken.

Your doctor or nurse will explain what to expect if you have a positive Cervical Screening Test.

How will I know when to have a test?

The new National Cervical Screening Register will send a letter inviting you to have a Cervical Screening Test.

If you have had a negative Pap test since December 2015 you will be invited 2 years after your last test for your first Cervical Screening Test. If the Cervical Screening Test is negative your next test will be in 5 years.

If you are currently undergoing surveillance or treatment for a previous abnormal Pap test your doctor or nurse will explain what tests you need and when you should have them, as you transition to the new screening program.

If you have already had a Pap test and are not yet 25 years of age you will be advised about the timing of the Cervical Screening Test when your next test is due.

Is it safe for me to wait until 25 for my first test?

It is safe to have your first Cervical Screening Test at the age of 25 years because:

  • cervical cancer is very rare in young women
  • young women are protected by the HPV vaccine. The National HPV Vaccination Program is reducing the rates of HPV infection and cervical pre-cancers. Its impact will increase as more young people are vaccinated.
  • HPV infection is common in young sexually active women and usually clears by itself
  • the cervical screening program has not shown a difference to the detection of cervical cancers for women under 25.
  • Young women should still see their doctor if they have any unusual bleeding from the vagina, such as bleeding after sex. This may be a sign of abnormal cells on the cervix

If you have had any sexual activity before 14 years of age, you can ask your doctor or nurse about having a Cervical Screening Test at an earlier age.

What if I've had the HPV vaccine?

If you have received the HPV vaccine it is still important to have regular Cervical Screening Tests. While the vaccine prevents most types of HPV infection it does not prevent all of them.

Talk to your doctor or nurse if you missed out on the HPV vaccine at school as it may still be useful for you to have it.

Can I do the test myself?

We know that most women who are diagnosed with cervical cancer have either never been screened or have been screened less often than they should.

In the new program a self-collected Cervical Screening Test will be possible within a clinic setting for some women. It involves inserting a swab into the vagina and placing it into a collection tube which is sent to the pathology laboratory for HPV testing. A self-collected test is less accurate than a Cervical Screening Test performed by a trained doctor or nurse, and for this reason a clinician-collected sample is preferred.

There are several 'self-testing' home-based kits being advertised in Australia which are not part of the National Cervical Screening Program and are not recommended.

Is there anything else I need to know?

If you have any questions or concerns it is useful to write them down to ask your doctor or nurse.

It is also important to see your doctor or nurse if you have any unusual pain or bleeding from the vagina. This includes bleeding after sex, bleeding in between your periods or bleeding after menopause. While there are many less serious causes for these symptoms they can sometimes be a sign of pre-cancerous changes on the cervix or, more rarely, with cancer.

For more information

Contact Family Planning NSW Talkline on 1300 658 886 or talk to your local health care professional.

 

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