Australia is renowned for its low cervical cancer rates, largely due to the National Cervical Screening Program (NCSP) in 1991 and the more recent introduction of the Gardasil vaccine. Since then, the NCSP has revolutionised cervical health through HPV testing, significantly reducing both cervical cancer incidence and mortality. 

With new NCSP guidelines coming into effect from April 2025, a new educational series has been launched to keep healthcare professionals informed. Supported by the Department of Health and Aged Care, it provides the latest updates and guidance. 

This initiative reinforces Australia’s commitment to effective cervical cancer prevention. Stay informed about the updated cervical screening guidelines in Australia to ensure continued success. 

5 Key Changes to Cervical Cancer Screening Guidelines 

Change 1: Universal Access to Self-Collection 

All screening participants aged 25-74 now have the option of HPV testing on either a clinician-collected or a self-collected sample. Previously, the criteria for self-collection was restricted to certain population groups, but is now an option for all women, to improve accessibility and acceptance of cervical screening. This aims to reduce barriers and improve participation, particularly for under-screened groups, reinforcing the National Cervical Screening Program’s commitment to inclusive cervical cancer screening in Australia. 

Change 2: Refinements to ‘Intermediate Risk’ Pathway 

For individuals who test positive for oncogenic HPV (not types 16/18) and have negative or low-grade cytology (either reflex LBC or collecting a cervical sample), the updated cervical screening guidelines clarify that a 12-month follow-up HPV test is necessary. Importantly, if a person who tested positive for HPV (non 16/18) on a self-collected sample does not return within 9 months for a cervical sample to be collected, they may repeat a self-collected HPV test to check if the infection has cleared. 

Change 3: Test of Cure After HSIL Treatment Uses HPV Testing 

Individuals treated for high-grade squamous lesions (HSIL, CIN2/3) will now undergo annual HPV testing until two consecutive tests show no HPV detected. Previous guidelines called for co-testing (HPV plus cytology); now, HPV testing alone suffices, with co-testing available in certain scenarios, such as positive excision margins. 

Change 4: Extended Follow-Up for Adenocarcinoma In Situ 

Follow-up testing after completely excised adenocarcinoma in situ (AIS) with clear margins can be extended to testing every three years once there have been five negative annual co-tests in a row (oncogenic HPV not detected and LBC negative). 

Change 5: New Recommendations for Older Patients 

Patients aged 70 years or older can exit the cervical screening program after completely excised AIS if they have undergone at least one co-test at age 70 or older, with no oncogenic HPV detected and a negative Liquid-Based Cytology (LBC) report. 

Action Steps for GPs 

There are many steps that GPs can take to enhance cervical cancer screening among their patients, taking into account the updated clinical guidelines: 

Offer all sampling methods: Discuss the new universal option for self-collection with all patients aged 25–74. Emphasise that both self-collection and clinician-collected HPV testing are now considered equally valid for routine screening. 

Update recall systems: Adjust your patient reminder/recall systems to align with the new follow-up intervals for those in the ‘intermediate risk’ group. 

Update patient education materials: Revise your patient information to reflect the new guidelines, emphasising the expanded self-collection options and simplified Test of Cure protocol. 

Attend training sessions: Take part in educational webinars and complete updated e-learning modules provided by organisations like GPEx to fully understand the guideline changes. 

FAQs 

Is a self-collection sample as accurate as a clinician-collected sample? 

Absolutely! Past studies suggesting lower accuracy with self-collection were based on older, signal-based HPV tests. Nowadays, newer PCR-based tests provide strong evidence that self-collected vaginal samples are just as reliable as clinician-collected ones. In Australia, laboratories must use these PCR-based tests for self-collected samples, so you can feel confident and well-informed about your testing choices. 

Is it possible for patients to take the self-collection swab home, and what happens if they don’t return it? 

Yes. While it’s often easiest to collect the sample in the clinic so it’s done on the spot, you can offer at-home swab collection if it suits your patient’s comfort and circumstances. In that case, make sure you provide clear instructions on handling the sample and use tools like electronic reminders to encourage prompt return. As the healthcare professional, it is your responsibility to explain the self-collection process, demonstrate proper technique if needed, and guide patients on returning the specimen. This ensures accurate and timely results, making the overall experience smoother and more reassuring. 

Will self-collection kits be mailed out to everyone? 

No. At this stage, the NCSP is not sending mail-out kits to everyone. We believe the personal connection between a healthcare provider and their patient is key to ensuring each person receives the appropriate care and follow-up. Under the NCSP Clinical Guidelines, providers have flexibility regarding where the sample can be collected—anywhere they deem most appropriate. This could include posting a swab directly to patients if it’s combined with a telehealth consultation and meets local needs. 

Does this change mean everyone must use self-collection? 

Not at all. If an individual prefers to have a healthcare professional collect the cervical sample, they may continue to do so. The main update is that individuals now have the choice between a clinician-collected cervical sample or a self-collected vaginal sample. Clinician-collected samples do offer a small benefit: if HPV (not types 16 or 18) is found, the lab can often perform LBC testing on the same sample, resulting in fewer clinic visits. Ultimately, it is about providing individuals with options so they can decide what is best for them. 

Discover our National Cervical Screening Program Bundle: (Link to modules) 

Resources 

National Cervical Screening Program Guidelines