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FAQs about the renewed Cervical Screening Program

Why is cervical screening changing?

Based on new evidence and better technology, the National Cervical Screening Program will change from 1 December 2017 to improve early detection and save more lives.

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What should women do before 1 December 2017?

It is very important that women continue to participate in the current two yearly Pap smear program to ensure they are not at risk of developing cervical cancer.

Pap smears have already halved the incidence and mortality from cervical cancer since the introduction of the National Cervical Screening Program in 1991.

Women will be due for the first Cervical Screening Test two years after their last Pap smear.

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How will the new Cervical Screening Test work?

The new Cervical Screening Test will detect human papillomavirus (HPV) infection.

The procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap smear. A Health Care Professional will take a small sample of cells from the woman’s cervix. The sample will be sent to a pathology laboratory for examination.

While the current Pap smear can detect abnormal cell changes, the new Cervical Screening Test will detect the HPV infection that can cause the abnormal cell changes, prior to the development of cancer.

Persistent HPV infections can cause abnormal cell changes that lead to cervical cancer. However, this usually takes a long time, often more than 10 years.

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Can I have the new Cervical Screening Test now?

Women aged between 18 and 69 who have ever been sexually active should continue to have their Pap smear when due. The new Cervical Screening Test will be available on the Medicare Benefits Schedule from 1 December 2017. Until then, it is important to undertake two yearly Pap tests to prevent cervical cancer.

Women of any age who have symptoms (including pain or bleeding) should see their Health Care Professional immediately.

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The new cervical screening test will only be offered every five years, why the change?

New evidence about cervical screening has found that screening for HPV every five years is more effective than, and just as safe as, screening with a Pap smear every two years. Because of this more effective test, women will only need to screen every five years, regardless of whether or not they have had the HPV vaccination.

The new cervical screening test detects HPV infection, which is the first step in developing cervical cancer. Persistent HPV infections can cause abnormal cell changes that may lead to cervical cancer. However, this usually takes a long time, often more than 10 years. While the current Pap smear can detect abnormal cell changes, the new Cervical Screening Test will detect the persistent HPV infection that causes the abnormal cell changes, that if left untreated, may eventually lead to the development of cervical cancer.

Screening every five years can detect persistent infections which may be of concern and avoids detecting infections that are likely to go away on their own within one to two years.

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When do I start having my five yearly screening?

After 1 December 2017 you can see your doctor or nurse for your new Cervical Screening Test. This will be two years after your last Pap smear.

This is because two years is the safe screening interval for the current Pap smear according to National Guidelines, and five years is the proven safe interval for the new Cervical screening Test.

If your result is not normal (HPV positive) your doctor or nurse will tell you what further testing or investigation is needed.

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Why will the screening age change to start at 25 years of age instead of 18?

From 1 December 2017, women will be invited to screen from 25 years of age. This change is because evidence shows that:

  • cervical cancer in young women is rare (in both HPV vaccinated and unvaccinated women).
  • The natural history of HPV infection is that, in many cases, especially in healthy, young, non- smokers, the immune system will eliminate the virus without treatment.
  • despite screening women younger than 25 years of age for over 20 years there has been no change to the rates of cervical cancer or rates of death from cervical cancer in this age group.
  • investigating and treating common cervical abnormalities in young women that would usually resolve by themselves can increase the risk of pregnancy complications later in life.
  • the HPV vaccination has already been shown to reduce cervical abnormalities among women younger than 25 years of age and, in contrast to screening, is ultimately expected to reduce cervical cancer in this age group.

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Should women under 25 years of age participate in cervical screening before 1 December 2017 when the renewed Program is implemented?

The National Cervical Screening Program currently recommends that all women who have ever been sexually active should start having Pap smears between the ages of 18 and 20, or one or two years after first becoming sexually active, whichever is later.

Until 1 December 2017, Women are advised to continue screening in accordance with this policy. However, if women have any questions about cervical screening and their individual situation they are encouraged to discuss these with their Health Care Professional.

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How will women be invited to screen using the new Cervical Screening Test?

From 1 December 2017, women aged 25 years or over who have not yet started cervical screening will receive an invitation to have the new cervical screening test.

The Cervical Screening Register will send an invitation to women to let them know they are due for their test and also remind women if they become overdue for their regular test.

Women already participating in the program will be invited to screen within three months of the date when they would have been due for their two yearly Pap test.

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When should I stop cervical screening?

Women between 70 and 74 years of age who have had a regular Cervical Screening Test will be recommended to have an exit HPV test before leaving the National Cervical Screening Program.

Women older than 69 years of age who have never been screened or not had regular screening tests should have Cervical Screening Test if they request screening.

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Will cervical screening prevent all cervical cancers?

No. There is no effective population based screening test for rare neuroendocrine cervical cancers. Given the current state of scientific evidence, neither the current Pap test nor the new Cervical Screening Test can effectively detect rare neuroendocrine cervical cancers.

The changes to the National Cervical Screening Program from 1 December 2017 are based on new evidence and better technology, and will improve early detection and save more lives.

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What is human papillomavirus (HPV)?

  • HPV is a common infection in females and males.
  • Most people will have HPV at some time in their lives and never know it.
  • There are more than 100 different types of HPV that can affect different parts of the body. HPV types 16 and 18 are most commonly associated with cervical cancer. Genital HPV is spread by genital skin to genital skin contact.
  • Most HPV infections clear up by themselves without causing any problems. Persistent genital HPV infections can cause cervical abnormalities, which, if they continue over a long period of time (more than 10 years), can lead to cervical cancer.
  • It is important to remember that most women who have HPV, clear the virus and do not go on to develop cervical abnormalities or cervical cancer.

For more information about HPV, please visit the You Got What - symptoms, treatment and prevention page

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How do I get human papillomavirus (HPV)?

Genital HPV is spread through genital skin to genital skin contact. Condoms are an important barrier to many sexually transmitted infections, but offer limited protection against HPV as they do not cover all of the genital skin.

Because the virus can be inactive in a person’s cells for months or years, for many people it is probably impossible to determine when and from whom HPV was contracted.

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What is the relationship between the human papillomavirus (HPV) and cervical cancer?

Persistent infection over many years with one or more cancer-causing types of HPV is the main cause of cervical cancer. In fact, 99.7 per cent of all cervical cancers are caused by HPV infection.

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Do I still need to screen if I have received the HPV vaccine?

Yes. The HPV vaccine does not protect against all types of HPV infection that are known to cause cervical cancer.

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Will the new Cervical Screening Test replace the vaccination program?

No. Eligible girls (and boys) should still be immunised to reduce transmission of HPV and help to protect the whole community against cervical cancer, as well as other HPV-related cancers such as throat and anal cancers.

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Will self-collection/self-screening be offered with the new program? 

Self-collection for HPV testing will only be offered for women who:

  • have never had a cervical screening test and are 30 years or over or
  • are under-screened defined as overdue for cervical screening by two years or longer and are 30 years of age or over.

The recommendation is that these women may be offered the option of self-collection in a clinical setting, such as a doctor’s surgery or Family Planning clinic. If the self-collected sample tests positive for HPV, the woman will need to return to her doctor or nurse for further testing or referral to a specialist.

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