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New cervical screening guidelines broaden self-collect options
The incoming guidelines bring simplification ‘without compromising quality and safety’ and increase the role of self-collection.
New Australian Cervical Cancer Screening Guidelines will come into effect in April this year.
Important changes to the Australian Cervical Cancer Screening Guidelines will take effect from April, offering women more opportunities for self-collection of cervical screening test (CST) samples.
These changes include offering self-collection for ‘test-of-cure’ surveillance following high-grade squamous intraepithelial lesions, changed criteria for immunodeficiency, and better supports around gender or sexual diversity.
GP Dr Lara Roeske, who sits on the implementation committee for the new guidelines, welcomes the changes, saying they offer ‘significant simplification’ to protocols with ‘no compromise to safety and quality’.
‘There are substantive changes to key management pathways that mean GPs need to update themselves around both the interpretation of results … and ensure they’re adhering to the latest management flows or pathways’ she told newsGP.
‘Many GPs have had the experience where, despite everyone’s best intentions and appropriate informing, the patient may not present in a timely manner for liquid-based cytology (LBC) follow-up when they had a non 16, non 18 human papillomavirus (HPV) detected.
‘There’s been some very sensible decision making around this, in this case, we don’t need to continue to chase the patient for the LBC follow-up, and they can be offered self-collected HPV testing.’
The new guidelines will also see women with high-grade changes, who have completed treatment, previously offered annual follow-up via clinician-collected LBC, now be offered self-collected HPV testing for annual surveillance for ‘test of cure’.
Other areas of changes in the revised guidelines include:
- better support for gender and sexually diverse patients
- broader (case-by-case) definitions around immune deficiency, with those with immune deficiency offered more frequent (three-yearly) screening
- changes to surveillance for women following treatment for adenocarcinoma in situ
- screening for women after hysterectomy
When self-collection for CST was first introduced, it marked a significant change for Australia’s cervical cancer screening program.
Providing a catalyst for changing attitudes and approaches to cervical screening among GPs and the community, self-collection has increased autonomy and choice for everyone eligible for CST.
Self-collection also holds the potential to increase participation amongst people at highest risk of developing cervical cancer, specifically those who have not previously engaged with the screening program, or who are overdue for their CST.
Dr Loeske said the guideline updates ‘support equitable access’, with increased participation from those living in rural and remote Australia and Aboriginal and Torres Strait Islander communities.
However, she said there are still women across Australia who are not aware of the self-collection option and that GPs continue to play a crucial role in this space.
‘It seems to me that there are many patients that we see on a daily basis that have no idea that self-collection is an option … so we’re doing a lot of the work around … offering the choice to either self-collect or have a clinician collected test,’ she said.
While the HPV vaccine is instrumental in achieving the goal of eliminating cervical cancer, screening remains crucial in increasing early detection of HPV and therefore the prevention of cervical cancer.
Reflecting on key learnings over the years since the new CST program was implemented, Dr Roeske said GPs have been doing a ‘fantastic job’ offering self-collection.
‘We have seen increased uptake of self-collection testing, particularly in those groups that we know haven’t had an equitable experience in the past, where a clinician-collected sample is a barrier,’ she said.
‘We see the enormous impact that the HPV vaccination [program] has had on the vaccinated cohort.
‘We’re not seeing those HPV types turning up so much now that we’re specifically able to look back, and that’s very reassuring.’
For more information, Dr Roeske is co-presenting, alongside Professor Deborah Bateson, the free ‘
2025 cervical screening update: What you need to know about the latest clinical guidelines‘ webinar on 13 March from 7.00 – 8.30 PM (AEDT).
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cancer prevention cervical cancer cervical screening cervical screening test HPV human papillomavirus immunisation papilloma screening virus
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