On December 1, 2017, cervical cancer screening in Australia changed from two-yearly Pap testing to five-yearly HPV testing.
Why did cervical screening change to five-yearly HPV testing?
We now know that 99% of cervical cancer is caused by persistent infection with certain types of HPV (human papillomavirus).
HPV is a common infection in females and males, with hundreds of different HPV types that affect different parts of the body.
Most HPV infections clear up by themselves without causing any problems. However, if they are not cleared naturally by the body, some types of HPV can lead to the development of different cancers.
Cervical cancer is most commonly associated with persistent infection with HPV types 16 and 18 (often called high-risk HPV).
How does the cervical screening test work?
All women aged 25 years and over are eligible for regular HPV testing as part of the Cervical Screening Program.
Sample collection for HPV testing is the same as having a Pap test - a doctor or healthcare professional collects a sample of cells from your cervix, and this sample is then sent to our pathology laboratory for testing.
From July 2022, self-collection became an option, which you can discuss with your doctor.
The laboratory performs an HPV test, and if HPV is found to be present, a cytology slide will also be made. This slide is examined under a microscope to see if there are any abnormal cells.
A cytology slide is also made for women who have had a previous abnormal Pap test, or who have symptoms such as abnormal bleeding.
Test results and repeat testing
Once all the testing is complete, the laboratory sends the result to your doctor with a risk category that indicates when you should have your next test. For more a more comprehensive explanation of the risk categories, please see the table below.
Remember, women of any age who experience symptoms, including pain, bleeding or discharge, should see their doctor or healthcare professional.
Frequently asked questions
The new cervical screening guidelines allow for additional testing in certain circumstances. This includes women who experience any abnormal bleeding, and young women who were sexually active before they received the HPV vaccination. Our laboratory will classify your results as 'symptomatic'. Your doctor will notify you of the result and any further investigations that may be required.
Yes. The vaccine does not protect against all types of HPV infection that are known to cause cancer, so you will still need to have the cervical screening test.
In the new program, liquid-based cytology tests, like ThinPrep®, only receive a Medicare rebate when HPV is identified in the initial test, or for patients who have symptoms or a history of previous abnormality.
If you would like the added reassurance of a second test, even if your HPV result is 'low risk', please ask your doctor whether adding a privately funded liquid-based cytology test, such as ThinPrep®, is appropriate.
The HPV test offered under the screening program will only be funded every five years for women who are 'low risk', with no symptoms or abnormal history.
If you prefer not to wait five years for your next screening test, more frequent cervical screening can be done, but it will not be eligible for a Medicare rebate unless it meets the specific criteria for increased testing. Again, please discuss this option with your doctor.
It is worthwhile being aware that all screening tests have an inherent, but low, probability of error. It is expected the new cervical screening test will increase detection of abnormalities compared to the previous Pap test. Please consult your doctor if you have any new or abnormal symptoms or concerns, even if you have had a recent 'low risk' cervical screening test result.
The resources below are provided to help you understand the changes introduced with the National Cervical Screening Program.
For further information on the new program, and for any questions you might have, please speak to your doctor.