Important changes to the National Cervical Screening Program's Clinical Guidelines pathway for women at intermediate risk

Changes to the NCSP's Guidelines for the clinical management of women at intermediate risk will come into effect from 1 February 2021. This follows the Cancer Council Australia Clinical Guidelines working party review of national data from the renewed program.

Date published:
Health sector

The Cancer Council Australia Clinical Guidelines working party has reviewed new Australian data provided by the National Cancer Screening Register.

A review of the national clinical program data was undertaken for women at Intermediate risk, whose follow-up test is Human papillomavirus (HPV) (not-16/18) positive, liquid-based cytology (LBC) prediction negative, possible low-grade squamous intraepithelial lesion or low-grade squamous intraepithelial lesion. 

Results from the review showed that these women will have a low likelihood of histologically-confirmed high grade squamous intraepithelial lesion (CIN2/3) or worse.

It is now recommended that:

Women with a 12-month follow up HPV (not-16/18) result with LBC prediction negative, pLSIL or LSIL (intermediate risk result) should be recommended to undertake a further HPV follow up test in 12 months’ time following their previous HPV test instead of referral to colposcopy.

Some groups of women may be at higher risk of harbouring a high-grade abnormality and should be referred to colposcopy if HPV is detected at 12 months, regardless of the LBC result. These include:

  • women 2 or more years overdue for screening at the time of the initial screen
  • Women who identify as being of Aboriginal or Torres Strait Islander
  • Women aged 50 years or older.

The new recommendations will come into effective from 1st February 2021.

The revised Cervical Screening Pathway flowchart

The image shows the revised Cervical Screening Pathway, which has been updated to reflect the new recommendations.  It is highlighting the changes to the new pathway women at Intermediate risk. The Recommendations for follow-up testing and investigation table on our health professionals page outlines the full details of the pathway changes

Find out more

Visit the NCSP Clinical Guidelines online – the new updates will be available from 1 February 2021.

For more on the changes read our frequently asked questions fact sheet.

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