From 1 July this year, the National Cervical Screening Program (NCSP) will expand screening test options, offering self-collection as a choice to all people participating in cervical screening. Self-collection allows screening participants to have the ability to take their own vaginal sample for HPV testing; for many people removing a significant barrier to participation in screening.
This means that all NCSP participants aged 25-74 years will have the choice to screen either by a self-collected vaginal sample or a clinician collected sample from the cervix (accessed through a healthcare provider in both cases). Healthcare providers are well placed to talk with patients about their cervical screening options to help them make an informed choice.
Self-collection provides a level of control and choice for patients, removing a significant barrier to participation in screening.
There are some groups that are less likely to screen, including:
Self-collection may be more acceptable to these groups.
Recent evidence has shown that the sensitivity and specificity of HPV testing to detect CIN2+ in self-collected samples were similar to those for clinician-collected samples when using validated PCR-based HPV assays.
A self-collected sample is taken from the vagina (not the cervix). It can be tested for the presence of the human papillomavirus (HPV) but not cytology (cervical cell abnormalities). If HPV is detected on a self-collected sample, depending on the type of HPV, it is recommended a patient should have a speculum examination with a cervical sample collected for liquid-based cytology (LBC), or be referred directly for colposcopy.
Self-collection of Cervical Screening Tests will be available for everyone who is eligible for the National Cervical Screening Program (NCSP), making it easier to participate, especially for people who have never screened or do not screen regularly. Updated NCSP clinical guidelines now provide the latest advice on the expanded eligibility to screen via self-collection, preparing health professionals for upcoming changes to the NCSP.
The updated guidelines won’t come into effect until 1 July 2022, but you can download a PDF version of them now on the NCSP Clinical Guidelines website.NCSP Clinical Guidelines
"Self-collection will be such a help for women who have previously avoided screening due to inability to tolerate a speculum exam. Some women have avoided cervical screening for decades due to pain with previous procedures and now we have an option for them."
Self-collection can make cervical screening easier for some people. Talk to your patients about this option.
"I feel uncomfortable about cervical screening"
"Did you know you can collect your own sample?"
Cervical Screening Pathway Flowchart (clinician collected or self-collected)
How to take your own sample for a HPV test
The cervical screening flipchart was developed as an educational tool to raise awareness among Aboriginal women to encourage the uptake of cervical screening.
To order a copy of this resource, please contact the WACCPP at email@example.com
Supporting your patient's choice: the expansion of cervical screening self-collection
Cancer Screening 2022 - Can I collect my own sample for cervical screening?
Unlike a clinician-collected sample, a self-collected sample is taken from the vagina (not the cervix). It can be tested for the presence of the human papillomavirus (HPV) but not cytology (cervical cell abnormalities). If HPV is detected on a self-collected sample, depending on the type of HPV, it is recommended the patient should have a speculum examination with a cervical sample collected for liquid-based cytology (LBC), or be referred directly for colposcopy.
From 1 July 2022 all NCSP participants aged 25-74 years will have the choice to screen either by a self-collected vaginal sample or a clinician-collected sample from the cervix, accessed through a healthcare provider in both cases.
Prior to 1 July, access to self-collection is only available for those over 30 years or older whom are more than two years overdue for screening or have never screened.
Self-collection is not suitable if the participant requires a co-test because they:
Prior to 1 July 2022, self-collection is also not available to those under 30 years of age.
The requirements for requesting and processing self-collected tests differ across laboratories. If you have any questions regarding this process, contact your local pathology laboratory directly.
In Australia, the processing of self-collected vaginal samples for HPV testing under the NCSP is currently supported through three accredited pathology laboratories. These are:
All pathology laboratories in Western Australia have arrangements with an accredited laboratory and can accept self-collected samples.
No. Recent evidence has shown that the sensitivity and specificity of HPV testing to detect CIN2+ in self-collected samples were similar to those for clinician-collected samples when using validated PCR-based HPV assays.
A self-collected Cervical Screening Test detects HPV DNA at levels associated with the presence of CIN2+ shed from the cervix. Therefore, as long as the sample is collected from the vagina, it will be accurate.
Patients that have difficulty collecting a lower vaginal sample by themselves could be assisted to do so by a healthcare provider. Alternatively, the provider could collect the sample using a self-collection swab without using a speculum. A sample collected in this way is still classified as self-collection on the pathology request form.
Among those attending for routine screening, approximately 2% have HPV 16/18 detected and approximately 6% have HPV (not 16/18) detected, although the latter varies by age. Over 90% test negative and can safely return to screen in five years’ time
When deciding whether to choose self-collection or clinician-collection, patients must be given clear information by their healthcare provider about the likelihood that HPV may be detected and, if so, what follow-up will be required.
The National Cancer Screening Register (NCSR) enables healthcare providers to access and submit cervical screening data electronically in a self-service fashion.
To access and submit cervical screening data, contact the NCSR on 1800 627 701 or visit their website.