The New Cervical Screening Program

On December 1 2017, the Pap test was replaced with a new Cervical Screening Test (CST).

The CST is a more accurate, effective and safe test to have every 5 years instead of the 2-yearly Pap test.

What is the new Cervical Screening Test?

The new CST is taken in the same way as a pap smear, with a speculum examination, so it will feel the same to you. The way the sample is stored and tested is different. The new CST detects infection with Human Papillomavirus (HPV), which causes over 90% of cervical cancers.

Do I need a Cervical Screening Test?

If you are a woman aged 25 to 74 years of age and have ever been sexually active you should have a Cervical Screening Test every 5 years until the age of 74. Your first Cervical Screening Test is due at 25 years of age or two years after your last Pap test. If your results are normal you will be due to have your next tests in 5 years.

All women aged 25 and over should have cervical screening regularly even if they have had the HPV vaccination. Cervical cancer is preventable with regular Cervical Screening. By having your 5 yearly CST you are preventing cervical cancer.

A five-yearly Cervical Screening Test is more effective than two-yearly Pap test

Evidence shows that screening for HPV every 5 years is just as safe as, and more effective than, screening with a Pap smear every 2 years. Most women and men will become infected with HPV at some point in their lives. The virus is so common that it can be considered a normal part of ever being sexually active. In most cases the virus clears up by itself within 1-2 years.

Starting cervical screening at age 25 is safe

The International Agency for Research on Cancer recommends that cervical screening commence at the earliest at age 25 because “there is minimal benefit and substantial harm in screening below age 25” (IARC 2005). It is a fact that screening before the age of 25 does not prevent cervical cancer. Cervical cancer is rare in women under 25 years, and and rates in this age group have remained unchanged in Australia despite screening. Screening before the age of 25 can cause harm because it leads to many women receiving treatment for cell changes caused by HPV that would never have become cancers but were destined to resolve on their own.

HPV vaccination and cervical cancer

The HPV vaccine protects against the 2 highest risk types of HPV (types 16 and 18). These cause approximately 70% of cervical cancers. There are other types of HPV that can cause cervical cancer, so regular cervical screening is still very important whether you’ve been vaccinated or not.

The National Cancer Screening Register

From December 2017 the Tasmanian Cervical Screening Register will be merged into the National Cancer Screening Register (NCSR). The Register will invite and remind women to participate in the NCSP.

Self-collection: why, who and how?

Self-collection for cervical screening will be available for eligible women. 80% of cervical cancers occur in women who are overdue for, or who’ve never had cervical screening. To help increase the number of women participating in the Cervical Cancer Screening Program eligible women can opt to self-collect a vaginal sample for HPV testing, rather than having a sample collected at a speculum examination. You will need to see your GP to access a self-collection kit, and your GP will explain how to collect the sample. Eligibility for self-collection is restricted to women aged over 30 who have never screened or are more than 2 years overdue for their test (ie. Four years or more since their last Pap test, or seven years or more since their last Cervical Screening Test). Self-collection under the supervision of a health-professional aims to improve screening participation in Indigenous, culturally and linguistically diverse women, and those who are under- or never-screened. Self-collection is not suitable if you are pregnant, or think you might be pregnant, or are experiencing unusual bleeding, pain or discharge. If the test detects HPV then you will need to see your GP to have a speculum examination or to be referred for colposcopy.

What is colposcopy?

Colposcopy is a specialist examination of the cervix using a magnified light source. The aim of diagnostic colposcopy is to assess the nature, severity and extent of any abnormality. It is an outpatient procedure that requires a vaginal speculum examination. If an abnormality is identified on the cervix, a small biopsy is usually taken for pathology and, depending on the rest results, may require a local treatment of the cervix.