Future changes to cervical screening

Page last updated: 10 May 2015

The Australian Government has accepted the recommendations of the Medical Services Advisory Committee (MSAC) that a primary human papillomavirus (HPV) test should replace the current Pap test for cervical screening.

What are the changes?

  • The renewed National Cervical Screening Program will invite women aged 25 to 74 years, both HPV vaccinated and unvaccinated, to undertake an HPV test every 5 years.
  • Women of any age who have symptoms (including pain or bleeding) should have appropriate clinical assessment, which may include a cervical cytology test and an HPV test.
  • HPV vaccinated women will still require cervical screening as the HPV vaccine does not protect against all the types of HPV that cause cervical cancer.
  • A 2015-16 Australian Government Budget commitment provides funding to implement these recommended changes to the National Cervical Screening Program and establish a National Cancer Screening Register to support the new programme.
  • The new programme will commence on 1 May 2017 when the primary HPV screening test will become available on the Medicare Benefits Schedule.
  • More information on the MSAC recommendations is available at MSAC recommendations

Why is cervical screening changing?

  • From 1 May 2017, evidence based changes to the National Cervical Screening Program, together with HPV vaccination, will reduce the number of cervical cancers by at least an additional 15 per cent.
  • A primary HPV test every 5 years can save more lives and women will need fewer tests than in the current 2 yearly Pap test program.
  • These changes will ensure that Australia stays at the forefront of cervical cancer prevention.

What should women do between now and 2017?

  • In the interim, it is very important that women continue to participate in the current two yearly Pap test programme to ensure they are not at risk of developing cervical cancer.
  • Pap tests have already halved the incidence and mortality from cervical cancer.

How does the new cervical screening test work?

  • The new cervical screening test detects human papillomavirus (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 test can detect abnormal cell changes, the new cervical screening test will detect the persistent HPV infection that causes the abnormal cell changes, prior to the development of cancer.

Diagram: The role of HPV infection in the development of cervical cancer


Text version of diagram

  • The procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap smear. A doctor or nurse would still take a small sample of cells from the woman’s cervix to send away to a laboratory to be examined.

Can I have the new cervical screening test now?

  • Women of any age who have symptoms (including pain or bleeding) should have appropriate clinical assessment and see their doctor immediately.
  • The new cervical screening test will be available on the Medicare Benefits Schedule on 1 May 2017.
  • Until 1 May 2017, it is important to undertake two yearly Pap tests to prevent cervical cancer.
  • Women participating in the Compass trial may be offered the new cervical screening test prior to 1 May 2017. Information is available at Compass trial website.
  • The new test is not currently available on the Medicare Benefits Schedule because there is a need to first develop and implement:
    • consumer resources and health professional training;
    • new clinical guidelines for women with a positive test result;
    • new pathology laboratory performance measures and standards;
    • workforce changes; and
    • register changes.
  • These activities are designed to enable the successful and safe delivery of the renewed program.

Why should I start cervical screening at 25 years of age?

  • Evidence shows that:
    • cervical cancer in young women is rare (in both HPV vaccinated and unvaccinated women);
    • screening women younger than 25 years of age has not changed the number of cases of cervical cancer or deaths 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; and
    • HPV vaccination has already been shown to reduce cervical abnormalities among women younger than 25 years of age and will continue to reduce the risk of cervical abnormalities in this age group.

When should I stop cervical screening?

  • Women between 70 and 74 years of age who have had a regular screening test will be recommended to have an exit HPV test before leaving the cervical screening programme.
  • Women older than 69 years of age who have never been screened or have not had regular screening tests should have an HPV test if they request screening.

Will cervical screening prevent all cervical cancers?

  • There is no effective population screening test for rare neuroendocrine cervical cancers.
  • Neither the current Pap test nor the new cervical screening test (primary HPV test) effectively detects rare neuroendocrine cervical cancers.

I am HPV vaccinated, so why do I need to have cervical screening tests?

  • The current HPV vaccine provides protection against about 70 per cent of cervical cancers.

What is the relationship between the Human Papillomavirus and cervical cancer?

  • HPV is the virus that causes more than 99 per cent of cervical cancer.
  • HPV is a virus that is a very common cause of infection in humans, similar to the common cold. Most women get it at some point in their lives. There are many types of HPV infections, and most of them clear up by themselves without causing any problems.
  • HPV is transmitted through sexual activity. HPV infections are very common in young women and men in the early years of sexual activity.
  • HPV infections are transient and will usually clear by themselves within 1-2 years. If the infection is not cleared, there is an increased risk of 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.
  • The HPV vaccine protects against the most common strains of HPV, accounting for approximately 70% of cervical cancers.
  • More information about the link between HPV and cervical cancer

Cervical Cancer Facts (AIHW 2012)

  • In 2011, 801 women were diagnosed with cervical cancer and there were 226 deaths from cervical cancer in 2012.
  • Between 1991 and 2010, the number of new cases of cervical cancer in women aged 20-24 years was approximately 10 per year (range 4 to 18). There have been 0 to 2 deaths per year in women aged 20-24 years over this same period.
  • In Australia, 80 per cent of women with cervical cancer have not been screened or have not had regular screening tests.