The role of health professionals in the National Cervical Screening Program

Health professionals and providers can help women understand the importance of regular cervical screening. Find out how you can help increase their understanding of the importance of regular cervical screening.

Your role

You play an important part in the program. By sharing your knowledge, you’ll increase understanding of, and participation in, the program.

You can:

  • tell patients about the benefits of cervical screening and their options for having a Cervical Screening Test
  • explain how the new test looks for human papillomavirus (HPV)
  • explain the difference between self-collected and clinician-collected samples
  • advise how and when the results are provided
  • remind them that after their first Cervical Screening Test, screening is every 5 years, if no HPV is found.
  • reassure them that it’s a straightforward process that is private and confidential.

Refer to our Healthcare provider toolkit. The information in the toolkit helps support you to learn about the National Cervical Screening Program, support patients before, during and after a screening appointment and tailor support to specific groups of people.

Clinical guidelines

Evidence-based clinical practice guidelines for this program – the National Cervical Screening Program Guidelines – are available on the Cancer Council Australia website. They should be used to guide your decision making and help you follow best practice in managing screen-detected abnormalities, cervical screening and investigation of symptoms in your patients.

Read our fact sheet on recent changes to the clinical management of women at intermediate risk.

Clinical resources

Manage participants via the National Cancer Screening Register

Visit the National Cancer Screening Register’s website to:

  • check patient screening histories 
  • receive reminders for patients overdue for screening or follow-up
  • check and update patient details
  • manage patient program participation.
  • submit information about your patient, such as colposcopy information
  • nominate other people to assist your patient, including another doctor or a personal representative.

National Cancer Screening Register contact

Contact the National Cancer Screening Register to update your contact details or if you have questions about either the National Bowel Cancer or National Cervical Screening Programs. You can call between 8am and 6pm Monday to Friday, except national public holidays, from anywhere in Australia.

Processing of self-collection samples

Providers of medical pathology services must clearly identify self-collected vaginal samples for HPV testing as part of the National Cervical Screening Program. This includes referring self-collected vaginal samples onto a laboratory who is accredited to process them, where necessary.

There is a range of collection devices and methods available for use under the National Cervical Screening Program for self-collected vaginal samples. As a result, different pathology laboratories may have varying collection and handling instructions and requirements.

Healthcare providers are encouraged to talk to their usual pathology provider in the first instance to:

  • confirm that they can process self-collected vaginal samples, or
  • confirm that they are able to refer self-collected vaginal samples to an accredited laboratory, if necessary, and
  • order the correct collection device and other consumables for offering self-collection, and
  • confirm any collection, handling and transport requirements.

Self-collection devices and methods currently available, and laboratories accredited to process them, include:

Copan 552C dry flocked swab, red topped

These swabs are delivered dry to the laboratory for processing.

If your local pathology provider is unable to process these types of self-collected samples or is unable to refer samples to an accredited laboratory for processing, healthcare providers can contact accredited laboratories directly to arrange for processing of the sample.

Pathology laboratories accredited to process these types of self-collected vaginal samples are:

Copan 552C.80 dry flocked swab, red-topped (Roche validated)

These swabs must be re-suspended into a collection vial (e.g. ThinPrep) at the time of collection. The collection vial is then delivered to the laboratory for processing.

This collection type is only available for self-collection in a clinic setting. Talk to your local laboratory about collection and handling requirements for processing these types of self-collected vaginal samples.

Laboratories accredited to process these types of self-collected vaginal samples are:

New South Wales:

Queensland:

Victoria:

Western Australia:

Copan 5E089C dry flocked swab, white topped (Becton Dickinson validated)

These swabs are delivered dry to the laboratory for processing. Talk to your local laboratory about collection and handling requirements for processing these types of self-collected vaginal samples.

Laboratories accredited to process these types of self-collected vaginal samples are:

Impact of COVID-19 on cervical cancer screening

The National Cervical Screening Program (NCSP) is still operating during the COVID-19 pandemic. The National Cancer Screening Register (NCSR) is still sending reminder letters and following-up patients who are overdue for the recommended further investigation.

If you decide to defer your patient’s Cervical Screening Test or follow up:

  • notify the NCSR of your decision to reschedule via phone or complete their online form
  • state how long you want to defer for. This allows the NCSR to send reminders at the right time.

The tables below contain guidance for managing NCSP screening during the COVID-19 pandemic.

Recommendations for screening

Patient circumstances

Recommended action

Patient with symptoms that require further investigation, such as:

  • unexplained abnormal vaginal bleeding after sex, between periods, or after menopause
  • unexplained persistent unusual vaginal discharge
  • deep pain during sex.

Assess and investigate according to the clinical guidelines.

 

New screener – recently turned 25

Reschedule if necessary for 3 to 6 months’ time.

Rescheduling screening appointments in this group is low risk because they were offered HPV vaccination at school. They have substantial protection either through direct HPV vaccination or through herd immunity.

Routine screener

No action needed. Anyone who has been screened since 1 December 2017 is not due again until at least 2022.

Overdue (more than 2 years since last Pap test)

Never screened (aged 30 or over and never had cervical screening)

Screen these patients as they present.

Offer patients self-collection as an option, if they prefer.

Recommendations for follow-up testing and investigation

Patient circumstances

Recommended action

Intermediate risk

  • Intermediate risk – HPV non-16/18 positive (with negative or low-grade cytology)

Follow up HPV test at 12 months where possible.

A delay of 3 to 6 months may be acceptable. We discourage delays of more than 6 months.

  • Follow up HPV test – HPV non 16/18 (possible high grade cytology or high-grade squamous lesion (HSIL)

Treated as Higher risk.

Refer immediately to a specialist for further investigation.

  • Follow up HPV test – HPV non-16/18 positive (with negative or low-grade cytology)

A 2nd Follow up HPV test at 12 months should be undertaken.

A delay of 3 to 6 months may be acceptable. We discourage delays of more than 6 months.

If your patient is:

  • 2 or more years overdue for screening at the time of the initial screen
  • identifies as Aboriginal or Torres Strait Islander
  • aged 50 years or older.

They may be at increased risk and should be referred immediately to a specialist for further investigation.

  • 2nd Follow up HPV test – HPV detected

Treated as Higher risk.

Refer immediately to a specialist for further investigation.

Higher risk

  • HPV 16/18 positive
  • non–16/18 positive with any of the following:
    • possible high grade cytology
    • high-grade squamous lesion (HSIL)
    • cancer
    • glandular abnormality.

Refer immediately to a specialist for further investigation.

Some colposcopy clinics are currently experiencing high demand and long waiting lists. If you are concerned about your patient being delayed, contact the specialist or clinic your patient has been referred to.

On the Test of Cure pathway

Continue with testing as scheduled wherever possible.

A woman who has been treated for HSIL (CIN2/3) should have:

  • a co-test performed at 12 months after treatment
  • annual tests thereafter.

Once she receives 2 consecutive negative co-tests, she can return to routine 5-yearly screening.

Cancer Council NSW reports

We asked Cancer Council NSW to model the possible impact of COVID-19 on our 3 national cancer screening programs. They examined a variety of scenarios and analysed the potential impact. Read their reports.

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