- Women under 25 should be offered testing only if they:
- Have symptoms of abnormal vaginal bleeding (unexplained post coital and/or intermenstrual bleeding)
- Have experienced first sexual activity before age 14 and before vaccination
- Are sexually active and have been immune-deficient for longer than 5 years
- Are yet to complete test-of-cure following a previous abnormality under the old program.
- Young women with previously normal Pap test(s) will be invited to join the new program at the age of 25 years.
- Women treated for a high-grade squamous intraepithelial lesion (HSIL=CIN2/3) before 1 December, who are yet to complete test of cure, should have an annual co-test (HPV+LBC) until both tests are negative on two consecutive occasions. Women still completing follow-up for a low-grade intraepithelial lesion (LSIL) or possible LSIL (pLSIL) should have a HPV test 12 months later at their scheduled appointment. If negative, then the next screen can occur at five years. Women with a positive oncogenic HPV (any type) test should be referred for colposcopy, regardless of the reflex LBC result.
- Women with normal colposcopy following HPV 16/18 and negative or pLSIL/LSIL reflex liquid based cytology in the new program should have an HPV test 12 months later. If that is negative, they can return to five-yearly screening.
- Symptomatic women with abnormal bleeding (unexplained post coital, intermenstrual or postmenopausal bleeding) should have a Co-Test (HPV+LBC) regardless of age or screening interval.
- Some women require more frequent screening and additional follow-up. These include immune-deficient women, DES-exposed women and some women following hysterectomy. Advice regarding management is clearly outlined in the guidelines.
- Upskilling opportunities: Online learning modules can be found at the end of the guidelines, and stakeholders such as NPS & Family Planning NSW also provide useful online resources and learning opportunities. You can also test your knowledge and earn CPD points on the How To Treat Website by clicking here.
Click here for the guidelines and practice recommendations.
*About the authors: Clinical Associate Professor Deborah Bateson is the medical director of Family Planning NSW. Dr Sally Sweeney is the organisation’s state medical coordinator.