The Department of Health is reminding GPs that from 1 July 2022, the National Cervical Screening Program will expand screening test options, offering self-collection as a choice to all people participating in cervical screening for the human-papillomavirus.
The change means that all women (and people with a cervix) between 25 and 74 years of age will now be able to use a simple swab to take a screening sample themselves, instead of having a traditional cervical screening test (CST) completed by a clinician.
Recent evidence has demonstrated that using a self-collected vaginal sample is just as accurate as a clinician-collected sample taken from the cervix during a speculum examination.
Current eligibility criteria restrict self-collection to women aged 30 years or over, who have never screened, or are two or more years overdue for cervical screening, as more than 70% of women diagnosed with invasive cervical cancer fall within these categories.
The NCSP said that self-collection may improve general screening participation and warned healthcare providers that they may start to see an increase in the volume of requests from patients to use self-collection for their CST.
Former Health Minister, Mr Greg Hunt, originally announced the changes back in November 2021, calling the move a game changer for the NCSP, with Australia one the first countries in the world to offer self-collection.
“By giving women the choice of how their screening is done, we are making the process easier, more comfortable, and less invasive,” Mr Hunt said.
“The self-collect tests will be accessed through health care providers, including GPs, ensuring these experts continue to play a critical role in supporting patients with cervical screening.”
The NCSP has advised that healthcare professionals still need to offer a consultation for cervical screening, explaining to their patients how to self-collect a sample, assessing patient risk and using their clinical judgement to recommend testing and follow-up.
“Healthcare providers must provide patients with clear information about the likelihood that HPV maybe detected and, if so, what follow-up will be required,” the NCSP said.
“Where self-collection is chosen, patients attending an in-person consultation should be encouraged to collect their sample while still at the clinic, as sample collection is considered more likely in this context.
“However, with the aim to maximise participation in cervical screening, collection of the sample can occur in any setting that the healthcare provider ordering the test believes is appropriate, including in the context of a telehealth consultation.”
Both the Department and the NCSP highlighted that by removing a significant barrier to participation in screening, self-collection is able to address hard to reach groups, such as Aboriginal and Torres Strait Islanders and people from culturally and linguistically diverse backgrounds.
A pilot demonstrated that 85.7% of never or under-screened women who declined a speculum examination, agreed to HPV self-collection when the test was offered to them in a sensitive and culturally appropriate manner, with appropriate follow-up advice.
The NCSP noted that self-collection may also be more acceptable to people who identify as LGBTIQ+, people with disabilities, people who have experienced sexual violence, post-menopausal women and people who have had previous negative cervical screening experiences.
GP practices are advised to talk to their local pathology laboratory to confirm that they support processing of self-collected samples (including referring samples to accredited laboratories for processing where necessary) and to order the correct swabs and other consumables.