From December 1, 2017, pap smears in Australia will be replaced by a new cervical screening test or HPV test. This article outlines what these new changes are and how clinics can smoothly transition to the new cervical screening program.
Why is this Important?
This change is not just a change in terminology, but a change in the way the tests are performed and what is analysed. Medicare will no longer cover the pap smear procedure starting December 1, 2017. This means patients will be sent a private invoice from the pathology company if a pap smear is mistakenly performed after this date.
The Key Changes
Eligible Age Group: The new age group to be tested will be 25 to 74 year olds. In the past the program covered 18 to 69 year olds.
Test Frequency: The test will now be conducted every 5 years, instead of the previous 2 years.
New Self-Collection Option: There is now a self-collection option for underscreened women over 30 years. Requirements and instructions can be found at cancerscreening.gov.au/cervical
The Test: Clinicians will no longer perform a pap test or pap smear. The new test to be performed is an HPV test from a cervical sample. This should be written in the pathology slip as Cervical Screening Test (CST).
What to Write on the Pathology Slip: It is important that all doctors and nurses providing cervical screening services are aware of what to write on the pathology slip. Words like ‘pap’ or ‘smear’ might result in the pathology company mistakenly providing the wrong test and subsequently charging the patient for it. Here is a Reference Table for what to write on the pathology slips.
Changes to the Recall & Reminder Process
Update Terminology: You will be required to update your practice recall and reminder system to reflect the new terminology, changing the wording from ‘pap smear’ to ‘cervical screening’.
From December 1 all women 25 to 69 years of age who are due for a routine pap test will instead be due for their first cervical screening test. The first cervical screening test is recommended 2 years after their previous pap smear.
Invite Women 70 to 74 Years of Age: You can also invite women in the 70 to 74 year group who were not covered by the previous program. These women can have what is being referred to as an ‘exit’ cervical screening to test for the presence of Human Papillomavirus (HPV) types, which may lead to cervical cancer. This exit test is also recommended from 2 years after the previous pap smear.
Delay Invitations for Women Under 25yrs: For women under 25 years, you will need to update the recall date of routine screening. Any existing recalls or reminders for routine pap smears for women under 25 years should be changed to a ‘cervical screening’ reminder, which is due from the time the woman turns 25 years old.
Assistance for HotDoc Clinics: If you are a HotDoc practice, your account manager can help you transition your Recall notifications and online appointment types to reflect the new terminology and age groups. We have also created a new Cervical Screening invitation template for practices using the HotDoc Recalls system. Talk to your Account Manager to find out more.
Practice Transition Tips
- Make sure all clinicians providing cervical screening services are aware that pap smears will no longer be funded from December 1. You may even want to consider placing signs in key areas of the consulting room to remind clinicians to pay close attention when annotating pathology slips to prevent miscommunication with the pathology lab.
- Check that you have sufficient stock of cervical screening collection kits. Talk to your pathology company to find out their preferred kit for sample collection as well as instructions on how to use that particular brand.
- NPS MedicineWise has created some comprehensive Free e-Learning Modules, which clinicians are highly encouraged to go through to ensure their cervical screening skills are up to date.
- Here are some other handy resources: Cervical Screening Information and Guidelines Relevant Patient Information
