This Self-Collection Policy of the National Cervical Screening Program aims to improve participation in screening by providing an alternative screening process for asymptomatic women1 who are under-screened or never-screened and have declined conventional screening via invitations and reminders from health professionals3 and the National Cancer Screening Register. The vast majority of cervical cancer in Australia occurs among this group of women. Healthcare professionals offering the self-collection option should have an empathic understanding of the barriers and reasons why women tend not to participate in cervical screening and utilise available and relevant resources to effectively address these barriers. Healthcare professionals should promote conventional screening, but inform and support women who decline conventional screening to undertake the alternative screening process.
The self-collection policy recommends:
- Self-collection of a sample for cervical screening for HPV testing is available for:
- women who have never participated in the NCSP and are 30 years of age or over; or
- women who are overdue for cervical screening by two years or longer2 and are 30 years of age or over.
- Self-collection for cervical screening must be facilitated and requested by a healthcare professional who also routinely offers cervical screening services;
- the self-collection device and the HPV test, when used together, must meet the requirements of the National Pathology Accreditation Advisory Council (NPAAC) Standards and Performance Measures4;
- women with positive HPV test results from a self-collected sample will require further tests and should be followed up in accordance with the NCSP: Guidelines for the management of screen detected abnormalities, screening women in specific populations and investigation of women with abnormal vaginal bleeding (2016 Guidelines).
1 Women with symptoms are advised to have a gynaecological examination (self-collection is not recommended)
2 During the early years of transition to the renewed program this includes both Pap and HPV tests i.e. greater than four years since last conventional Pap test or greater than seven years since last HPV test.
3 Healthcare professionals that provide cervical screening services may include but are not limited to medical practitioners and specialists as well as non-medical providers such as nurse practitioners, registered and enrolled nurses and Aboriginal health workers under the supervision of a medical practitioner; or non-medical providers such as registered and enrolled nurses and Aboriginal health workers in the public health system.
4 The performance of an HPV test can be different on self-collected vaginal samples compared to clinician collected samples therefore the HPV test and the self-collect device must be compatible in a way that the performance of the HPV test meets the requirements of NPAAC.