Quality and Safety Monitoring Committee Position Statement

The introduction of primary Human Papillomavirus screening in the National Cervical Screening Program

Page last updated: 22 October 2020 (this page is generated automatically and reflects updates to other content within the website)

The Quality and Safety Monitoring Committee (QSMC) was established in 2014 to provide advice on the quality and safety aspects of the National Cervical Screening Program (NCSP).

The QSMC supports primary human papillomavirus (HPV) screening, with reflex liquid-based cytology (LBC) triage where required, for women and is inclusive of any person with a cervix who is aged 25-74 years.

There is strong evidence that five-yearly screening with a primary HPV test will be more protective against cervical cancer than the Pap test program it has replaced. It is predicted to provide up to 30% greater protection from cervical cancer, with some evidence that this added protection may exceed 30%. Unlike the Pap test, HPV testing can detect elevations in risk before cervical abnormalities occur. In addition, HPV testing is more sensitive in detecting pre-invasive lesions.

Routine cervical screening with the HPV test is recommended for both HPV vaccinated and unvaccinated women, because the vaccine does not protect against all cancer-causing HPV types. Women who experience any symptoms suggestive of cervical cancer, such as unusual vaginal bleeding, discharge and/or pain, should see their healthcare provider irrespective of whether they are due for screening.

In response to the introduction of HPV-based screening from 1 December 2017, QSMC expects:

  • To see an initial increase in detected high-grade abnormalities and cervical cancers (with no increase in cervical cancer deaths). This is because the new Cervical Screening Test has a higher sensitivity than the Pap test.
  • The transition from a two-yearly to a five-yearly screening interval will create fluctuating volumes in screening participation, test results and colposcopy referrals. This will be closely monitored by QSMC.
  • Some women will choose self-collection of a vaginal sample for cervical screening as an alternative screening process. This testing method is currently reserved as a secondary option for under and never screeners to improve screening coverage.

To ensure the NCSP is performing as expected, during and after transition to the renewed NCSP, the role of the QSMC includes:

  1. Monitoring NCSP performance along each step of the screening pathway from recruitment to screening, assessment, diagnosis and treatment; and
  2. Monitoring the appropriateness of care.