Home > NHMRC Cervical Guidelines

NHMRC Cervical Guidelines

The latest guidelines from the National Health and Medical Research Council on the management of women without symptoms who have screen detected cervical abnormalities.

The NHMRC Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities

In June 2005 the National Health and Medical Research Council (NHMRC) approved the Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities. These guidelines replace the 1994 guidelines, which have been rescinded.

The new guidelines were formulated in line with recent NHMRC standards for clinical practice guidelines to assist women and health professionals to achieve the best outcomes in the management of abnormal Pap test results. The guidelines are based on epidemiological and scientific evidence and a new understanding of the role of HPV in cervical cancer.

The new guidelines address the:

current state of cervical cancer in Australia;
natural history of cervical cancer;
revised terminology for cervical cytology;
management of squamous abnormalities, glandular abnormalities and special clinical circumstances; and
psychosocial, economic and implementation issues.

Implementation of the guidelines will occur from 3 July 2006. At this time the Australian Modified Bethesda System 2004 (AMBS 2004) will be introduced to replace the pathology reporting system currently in use. The implementation period is deliberately long, allowing for a smooth transition to the new terminology and practices.

A national steering group has been established to guide the process and provide input from professional bodies and consumers. The steering group is overseeing the development of resources including materials for consumers and health professionals. These products will be widely available before July 2006.

A Safety Monitoring Committee has been convened to monitor the safety of the guidelines, with particular reference to treated high-grade intraepithelial disease and low-grade squamous intraepithelial disease. The Safety and Monitoring Committee reports to the Screening Subcommittee of the Australian Population Health Development Principal Committee and will alert it should any concerns about the guidelines arise.

Since the endorsement of the new guidelines, states, territories and the Australian government have been working to standardise data collections in the eight Pap test registers across Australia. This has included drafting a national coding sheet for pathology laboratories reporting cervical cytology, standardisation of follow-up and reminder protocols across jurisdictions, and the development of a common data dictionary.

For further information on the new guidelines:

NHMRC Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities
Presentation on the revised guidelines (Note: CD of the powerpoint presentation can be ordered online)
Article - The new NHMRC guidelines for management of abnormal Pap smears in asymptomatic Australian women. This article has been reproduced with the permission of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, from O & G, Vol 7, No 3, Spring 2005 (with minor changes).

Top of page

Rural Health Education Foundation Satellite Broadcast

The new NHMRC Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities include a number of recommendations which will require health practitioners to change the way they manage women who are found to have a low-grade abnormality on their Pap smear. To assist in the implementation of the Guidelines the Australian Government contracted the Rural Health Education Foundation to undertake a rural health satellite broadcast to provide rural and remote health practitioners with practical advice on how best to manage the required change of practice.

The broadcast took place on 14 March 2006 and focussed on the changes to clinical management outlined in the Guidelines. An expert panel discussed these changes within the context of general practice, using case studies to highlight the management of women with diverse screen detected abnormalities. The panel was chaired by Dr Norman Swan and included Professor Ian Hammond (Director of Gynaecology, King Edward Memorial Hospital for Women, WA), Dr Stella Heley (Sexual Health Physician, Victorian Cytology Service, Melbourne), Dr Marion Saville (Pathologist, Victorian Cytology Service) and Dr Jenny May (Rural General Practitioner).

The objectives of the Program are that viewers will understand:

Revised management recommendations for women presenting with various abnormalities;
The new terminology for cervical cytology reporting in Australia;
The recommended rigorous safety monitoring and referral pathways; and
The need for monitoring, supportive care and follow up for affected patients.

Further information on the satellite broadcast and to view the broadcast as a webcast see http://www.rhef.com.au/programs/program-1/?program_id=89

To order a copy of the broadcast 'Cervical Cancer Screening is Changing: What You Need to Know' on DVD, please use the online order form.
The DVD version contains navigational aids, facilitator’s notes and an embedded copy of the NHMRC Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen detected abnormalities.

Page currency, Latest update: 16 March, 2007