You must order and oversee self-collection of a vaginal sample. You must also be able to provide timely collection of a clinician-collected cervical sample, if required as part of a follow-up assessment.
You are responsible for:
- facilitating access to, and return of, the self-collection swab
- labelling the sample as ‘self-collect’ on the pathology request form
- providing the sample to the laboratory for processing
- communicating the results and any follow-up requirements to the patient.
Health services should work out which practitioners will give self-collection consultations. Keep in mind that only doctors and nurse practitioners can sign pathology requests for Cervical Screening Tests under the MBS rules. Remember that patients who are not up to date with cervical screening are more likely to speak with you if they know and trust you.
All health services should maintain complete data on patients’ screening history. Staff can offer cervical screening to patients flagged in the patient records.
You can find out a patient’s screening history by accessing the Healthcare Provider Portal through PRODA. This provides a self-service alternative to access and submit cervical screening data electronically in the National Cancer Screening Register (NCSR). Practices using Best Practice, MedicalDirector and Communicare can integrate their practice systems with the NCSR to view their patient’s cervical screening record directly in a patient record. Visit NCSR.gov.au for more information.
Who is eligible for self-collection
Self-collection of a vaginal sample for screening is available as an option for:
- anyone who is eligible for cervical screening – women and people with a cervix aged 25-74 years who have ever had any sexual contact (which includes sexual intercourse, penetrative sex, oral sex, very intimate genital skin contact such as part of foreplay and anal sex)
- follow-up HPV testing after an intermediate risk result1
- cervical screening during pregnancy.
Encourage patients attending an in-person consultation to collect a sample while they are still at the clinic. Sample collection is more likely in this context. However, to maximise participation in cervical screening, self-collection can occur in any setting that you think is appropriate for that patient, including through a telehealth consultation.
Who is not eligible for self-collection
Self-collection is not appropriate if the patient requires a co-test, including patients who:
- are symptomatic (e.g. experiencing unusual vaginal bleeding, pain or discharge)
- are undergoing Test of Cure surveillance or been treated for a glandular abnormality
- have had a total hysterectomy with past history of high-grade squamous intraepithelial lesion
- were exposed to diethylstilbestrol (DES) in utero.
Patients with symptoms indicating cervical abnormalities or cancer need diagnostic testing. Manage them according to the National Cervical Screening Program Clinical Guidelines.
Managing self-collection results
Patients take a self-collected sample from the vagina (not the cervix). Vaginal samples can only be tested for HPV and not for cytology.
If the self-collected test detects HPV , depending on the type of HPV detected, the patient will either need:
- a speculum examination (to collect a sample of cells from the cervix for liquid-based cytology) to determine management
- to be sent directly for colposcopy.
You can find out more about cervical screening and collection options in these resources:
- NCSP clinical management pathway
- Self-collection quick reference guide
- Pathology Test Guide for Cervical and Vaginal Testing
 Note Medicare rebates for a self-collected sample at a follow up test for people whose initial screening test was clinician collected will be effective from 1 November 2022.