How has cervical screening changed?

Based on significant improvements in science, technology and research into the development of cervical cancer, a number of changes were introduced to the National Cervical Screening Program (NCSP) for December 2017.

What changed?

  • The Cervical Screening Test replaced the Pap test as the method of screening for changes that can lead to cervical cancer.
  • Women are due for their first Cervical Screening Test two years after their last Pap test (with a normal result). 
  • The Cervical Screening Test looks for human papillomavirus (HPV), the virus known to cause almost all cervical cancers.
  • A National Cancer Screening Register (NCSR) will support the operations of the Program by storing your screening results.

Who needs to screen?

  • All women between the ages of 25 and 74 who have ever been sexually active need to have a Cervical Screening Test.
  • Women who have had the HPV vaccination still need to have a Cervical Screening Test every five years.

How often do you screen?

  • Your first Cervical Screening Test is due two years after your last Pap test.
  • If this test is normal your next Cervical Screening Test will be in five years.  

Why the change?

  • The changes to the National Cervical Screening Program are expected to protect up to 30% more women from cervical cancer.

Information on these changes and how they benefit women:

What is the Cervical Screening Test?

The Cervical Screening Test replaced the Pap test as the method of cervical screening. The new test looks for HPV, an infection that can cause cells in the cervix to change and become abnormal.

As a result of HPV infection that doesn’t clear up, these cell changes can occasionally develop into cervical cancer. We now know that HPV infection is the cause of almost all cervical cancers.

Women of any age who experience symptoms, such as pain or unusual bleeding, should speak to their doctor or nurse immediately and not wait for their next Cervical Screening Test.

How is the Cervical Screening Test different to the Pap test?

The method of sample collection is the same in both the Pap test and the Cervical Screening Test – so if you’ve had a Pap test before, you won’t notice any difference at your screening appointment.

A Pap test (or Pap smear) looked for cells in the cervix that had changed or become abnormal. The Cervical Screening Test looks for HPV – the infection that causes these cell changes.

HPV: the facts

  • HPV stands for human papillomavirus
  • HPV is a very common outcome of being sexually active. For most people, the infection clears from the body naturally, without causing any symptoms, within 1–to2 years.
  • HPV infection that does not clear up can cause cells in the cervix to change. If left untreated, this can eventually develop into cervical cancer.
  • The length of time between getting HPV infection and that infection potentially turning into cervical cancer is usually 10–to15 years.
  • HPV infection is the cause of almost all cervical cancers.
  • The Cervical Screening Test looks for HPV to identify women at higher risk of developing cervical cancer.
  • The less than 1% of cervical cancers that are not caused by HPV are usually not able to be detected by any screening test, including the Cervical Screening Test or the Pap test.
I’ve had the HPV vaccine, do I need to have cervical screening?

Yes, you do. The HPV vaccine protects against the types of HPV that cause the majority of cervical cancers, but not all of them, so you still need to have regular cervical screening.  

What happens if I have HPV?

If your Cervical Screening Test shows that you have HPV, you won’t wait five years for your next test. Based on the type of HPV you have, and whether your cervical cells have started to change, you will be referred straight away for further tests, or you will have a repeat test in 12 months.

How did I get HPV?

HPV is transmitted through sexual activity – through genital skin-to skin contact. The HPV infection can be inactive in your body for a long period, so it can be very hard to say who passed the infection on to you.

It is a very common part of being sexually active. Around 80% of people will have an HPV infection at some time in their life.

How is the Cervical Screening Test more effective than the Pap test program?

The Pap test program was very successful in reducing cervical cancer incidence and mortality rates. However, we now know that almost all cervical cancers are caused by the HPV infection. 

This new information has allowed us to update the cervical screening method to detect HPV. In doing so, we can identify women at higher risk of developing cervical cancer and monitor or treat them to prevent this occurring.

International trials have found that testing for HPV (the Cervical Screening Test) is more effective and provides better long-term protection against cervical cancer than the Pap test.

The changes to the National Cervical Screening Program – in conjunction with the HPV vaccination – are expected to protect up to 30% more women from cervical cancer. 

When should I have my first Cervical Screening Test?

Cervical screening is for women aged between 25 and 74 who have ever been sexually active.

  • If you are over the age of 25 and you have been having Pap tests with normal results, your first Cervical Screening Test is due two years after your last Pap test.
  • If you are over 25 and have never screened, or it’s been longer than two years since your last Pap test – you should book an appointment now.
  • If you are under the age of 25 and cervical screening with normal results, it is safe to wait until you are 25 for your first Cervical Screening Test.
  • If you are aged between 70 and 74, you should have a final ‘exit’ test (two years after your last Pap test). If this returns a negative result, you won’t need to have any more screening.

Women of any age (including under 25 and over 70) who have had recent abnormal results will be advised of their next steps by their doctor.

Where do I have a Cervical Screening Test?

You don’t need to see a specialist for cervical screening, your local doctor or nurse can do the test.

You can search to find a cervical screening provider near you.

Why did the starting age for cervical screening change from 18 to 25?

The reason for updating the starting age for cervical screening is based on extensive research, which showed that:

  • Cervical cancer is rare in women aged under 25.
  • When young people do have a HPV infection, it is usually transient - meaning their immune system will clear it up and the infection won't cause harm. 
  • Most young women are protected against the main cancer-causing types of HPV through the HPV vaccine, and if they haven’t had it themselves, ‘herd immunity’ provides some level of protection.
  • After more than 25 years of screening women under 25, the data shows there is little benefit to screening, and it can actually cause some harm. Treatment for minor cell changes can cause pain, bleeding and risk of infection, plus a small risk of causing problems for future pregnancies. The vast majority of cell changes in young women clear up naturally, without ever needing treatment.

It's important to remember that this information is about screening. A screening test is one that is offered by routine, and is different to tests offered when people have signs or symptoms of an illness. 

At any age, if you have any signs that something is not right - such as unusual bleeding, pain or discharge - talk to your doctor as soon as you can. 

Find out more about eligibility for cervical screening.

Is screening every five years safe?

Yes, the Cervical Screening Test will prevent more women from developing cervical cancer than the two-yearly Pap test.

It usually takes around 10-15 years for cervical cancer to develop as a result of HPV infection that does not clear up, so checking for HPV every five years (through a Cervical Screening Test) is a safe way to identify women who are infected with HPV.

It is important to remember that the Cervical Screening Test is different to the Pap test - it is not the same test being offered less often. Screening every five years is for women who are HPV-negative (no HPV infection). The new Cervical Screening Test is more accurate than a Pap test, and the risk of developing cervical disease within five years after a HPV-negative result is low. 

It's important to remember that if you ever have any signs or symptoms, such as unusual bleeding or pain - don't wait until your Cervical Screening Test is due, and see your doctor as soon as you can. 

What is self-collection?

Due to low rates of participation in cervical screening among particular groups, some women who are not up-to-date with their cervical screening will be eligible to collect their own sample for testing, rather than a health professional collecting the sample.

Women will be eligible to self-collect a sample if they are aged 30 and over, and have either never had a screening test or are two or more years overdue for their screening test.

This self-collection is undertaken in private within a medical or healthcare clinic.

The NSW Cervical Screening Program recommends that women attend for screening when they are due and don’t delay their Cervical Screening Test for any reason.

Read more about self-collection for your Cervical Screening Test

What is the cost of the Cervical Screening Test?

There are two costs involved in having a Cervical Screening Test – the doctor’s consultation cost and the cost of the laboratory test. A Medicare rebate is available for both of these costs. Some practices and pathology laboratories ‘bulk bill’, which means there are no out of pocket expenses to you.

The cost of the doctor’s consultation will depend on the general practice or health centre you attend. You can ask what the cost will be when you make your appointment.

Were the changes to the National Cervical Screening Program just cost-saving measures for the Government?

No – the changes to the Program are based on significant improvements in science, technology and research about how cervical cancer develops since the Program was first introduced in 1991. The changes are expected to protect up to 30% more women from cervical cancer.

By detecting the virus which causes almost all cases of cervical cancer (HPV), the Cervical Screening Test is more effective and just as safe as the previous Pap test program.

For more information, download this NSW Factsheet for women: Information about the changes to cervical screening (PDF)

*In December 2017, the Cervical Screening Test replaced the Pap test as the method of screening women to prevent cervical cancer in Australia.