Changes to the National Cervical Cancer Program

For three decades, Australia has had a highly successful cervical screening program based on two-yearly Pap tests for women aged between 18 and 69 years.

A strong link between HPV infection and cervical cancer has been confirmed.

A more sensitive screening test has been developed which looks for the presence of oncogenic viral types rather than cellular changes caused by infection.

If a patient tests positive for HPV, then a Liquid Based Cytology (LBC) test will be performed.

What are the changes

The National Pathology Accreditation Advisory Council (NPAAC) has published new technical, quality and reporting requirements for laboratories participating in the National Cervical Screening Program.

These changes come into effect from 1 December 2017.

The change will see traditional primary Pap smears replaced with the Human Papillomavirus (HPV) test.

Testing will change from every two years for women aged 18 to 69, to every five years for women aged 25 to 74 years.

The change is based on evidence that PCR screening for HPV improves early detection of cervical cytology change which pre-dates cancer.

For patients, the sample collection process will remain the same.

The new National Cervical Screening Register will send invitations inviting women to screen, and reminders when their next screen is due. 

What this means for our patients

Age range for screening is now 25 to 74 years (instead of 18 to 69).

Time between tests is now five years (not two).

Pap smear is replaced with the Cervical Screening HPV Test.

Sample collection process is the same.

The new National Cancer Screening Register will invite women to screen, and remind them when their next screen is due.

Women who have had the HPV vaccine still require cervical screening (they are not protected against all types of HPV infection that are known to cause cervical cancer).

What this means for clinicians

A more sensitive screening test has been developed which looks for the presence of oncogenic viral types rather than cellular changes caused by infection.

If a patient receives a positive HPV test, then a LBC test will be performed.

Both tests can be carried out using the one sample.

Requests and samples can continue to be sent to your local NSW Health Pathology laboratory.

All cervical specimens should be collected as previously done for Pap smears, but the collection implement should be rinsed into a liquid based preservative (Thin Prep®).

The use of lubricant can interfere with testing. If required, small amounts of carbomer-free water soluble lubricant should be used.

There will be no Medicare rebate for conventionally prepared slides (Pap smears). If these are collected, the patient will be charged an out-of-pocket fee.

Clinical information must be provided on the request form sent with the cervical specimens to allow correct triage of specimens on receipt at the laboratory and to ensure your patient is bulk-billed for this test.

All cervical HPV, LBC and histology results will be reported to the new National Cancer Screening Register so there will be changes to the current report formats.

What it means for us

Due to new technical, quality and reporting requirements for laboratories, we’re now carrying out asymptomatic HPV screening tests at our dedicated laboratory in Newcastle.

The National Pathology Accreditation Advisory Council requires that labs doing the testing must perform a minimum of 2,000 tests in a six-week period.

HPV and Liquid Based Cytology requests will now be triaged upon receipt to determine if the request is diagnostic or screening. Routine screening for asymptomatic women will be sent to our lab in Newcastle.

Diagnostic testing on symptomatic women, will continue to be performed at our Camperdown, Westmead and Randwick laboratories.

We have been in contact with local clinicians and will continue to work with them to ensure a smooth transition to the new program.

Download the leaflet for healthcare professionals. (PDF 671.8KB)

Getting technical

To meet the requirements of the new National Cancer Screening Registry (NCSR), we also led a major, complex ICT initiative. 

For this, our ICT team worked as a single, centrally managed unit across the state in collaboration with external partners, eHealth and Deloitte.

We’re immensely proud to be the first in the country to have had the primary screening site tested, approved and signed-off by the Registry ahead of today’s (1 December 2017) go live date.

Achieving this was no mean feat and required:

  • New tests workflows had to be built within the LISes to support the laboratory changes
  • New test codes and associated billing had to be configured
  • Cloud based infrastructure was built to aggregate all NSWHP messages via a single connection to the Registry
  • Re-usable LIS interfaces were built to support extension of the NCSR to Bowel Cancer, and other registry connections
  • We will use the same LIS interfaces for private hospital connections, our inter-LIS messaging for send-aways and for our mobile app

If you have any questions, please contact our project manager for HPV screening, Ruth Yimsung 0418 823 451. If you want to know more about our ICT efforts, contact James Patterson, Director of ICT on 4920 4043.