Cervical cancer

Screening age range

• 25-74

Normal interval for screening & collection of probe

• every 5 years

• sample can be clinician-collected/ self-collected, according to the woman’s choice

Vaccination age range for the National Immunisation Program

• 9 → 26 years

• 1 dose

HPV-positive (type 16 or 18) result on a self-collected test

referred directly for colposcopy, with a liquid-based cytology (LBC) sample to be collected at colposcopy

HPV-positive (not type 16 or 18) result on a self-collected test

return for clinician-collected cervical sample for LBC to determine the risk category & next steps in the screening pathway

HPV not detected

5-yearly screening

HPV detected (not 16/18)

LBC - reflex or collect cervical sample (if self-collection was used)

• negative/pLSIL/LSIL

  • follow-up HPV test in 12 mo

• unsatisfactory LBC

  • repeat LBC in 6 we

• LBC pHSIL/ HSIL

  • colposcopy

At 12 mo follow-up HPV not detected

Routine 5 yearly screening

At 12 mo follow-up HPV (not 16/18) detected

do LBC

• unsatisfactory

  • repeat LBC in 6 weeks

• negative/ pLSIL/ LSIL

  • follow-up in 12 months

    • HPV not detectable → 5 yearly screening

    • HPV (any) detected → LBC → colposcopy

• pHSIL/ HSIL

  • colposcopy

At 12 mo follow-up HPV (16/18) detected

• do LBC

• any LBC result/ unsatisfactory

  • colposcopy

At 12 mo follow-up unsatisfactory HPV

repeat ideally within 6 weeks

When is direct referral to colposcopy indicated at the follow-up HPV test after 12 months (1st follow-up after HPV (not 16/18) detected)?

• ≥50 y

• Aboriginal

• overdue for screening ≥2 y at initial screening

HPV (16/18) detected

• LBC

• any LBC result/unsatisfactory

  • colposcopy

flowchart