If you’ve been putting off your cervical screening because you’re not sure what the test involves anymore — you’re not alone.
In December 2017, Australia replaced the two-yearly Pap smear with a new test — the Cervical Screening Test (CST) — that detects the human papillomavirus (HPV), the virus that causes almost all cases of cervical cancer. This was one of the most significant changes to women’s preventive health in Australia in decades, and nearly a decade later, many women are still unsure what it means for them.
The good news: the new test is more accurate than the old Pap smear, is needed less frequently (every 5 years instead of every 2), and since July 2022 can even be self-collected. Australia is now on track to become the first country in the world to eliminate cervical cancer as a public health issue.
Here’s everything you need to know.
Why Did Australia Change from the Pap Smear to the HPV Test?
The Pap smear — named after Dr George Papanicolaou, who developed it in the 1940s — looked directly for abnormal cells on the cervix. It was an enormously effective screening tool that halved cervical cancer incidence and mortality rates in Australia since the National Cervical Screening Program began in 1991.
But science moved forward. Research established that almost all cervical cancers are caused by persistent infection with certain strains of HPV — specifically the high-risk strains, most notably HPV 16 and 18, which together account for more than 70% of all cervical cancers.
Rather than waiting to detect the cell changes that HPV causes — which is what the Pap smear did — the new HPV test detects the virus itself, at an earlier stage. This provides 60–70% greater protection against invasive cervical cancers compared with a Pap smear.
Because HPV infection typically takes 10 or more years to progress to cervical cancer (and the body often clears HPV naturally within 1–2 years), a 5-year screening interval is safe and appropriate for women who test HPV negative — unlike the 2-year interval that was needed with the less sensitive Pap smear.
The new Cervical Screening Test is more accurate, requires less frequent testing, and better identifies the women who genuinely need further investigation.
What Are the Current Cervical Screening Guidelines in Australia?
The National Cervical Screening Program recommends that women and people with a cervix aged 25–74 have a Cervical Screening Test once every 5 years, provided they have ever had any sexual contact.
Key points about who this applies to:
Starting age is 25 — the age was raised from 18 because most women under 25 will have been vaccinated against HPV through the school program. HPV infections in women under 25 are highly prevalent but usually transient — the immune system clears them naturally — and there is limited evidence that screening before 25 prevents cervical cancer.
Upper age is 74 — screening continues until 74. Women who have always had regular negative results may be able to exit the program at 70–74 with a final test; your GP will advise.
Applies regardless of sexual orientation — cervical screening is recommended whether you are heterosexual, lesbian, bisexual, or identify otherwise. HPV can be transmitted through any form of sexual contact involving the genitals.
Applies even if you have been vaccinated — the HPV vaccine (Gardasil 9, now used in Australia) protects against the most high-risk strains, but not all cancer-causing types. Cervical screening remains essential even for vaccinated women.
Applies even if you have no symptoms — cervical cancer is often asymptomatic until advanced. Screening detects problems before symptoms develop.
Applies after menopause — you should continue screening until age 74, even if you are no longer sexually active or have been through menopause.
How Does the New Cervical Screening Test Work?
The HPV Cervical Screening Test collects a sample of cells from the cervix and tests them for the presence of high-risk HPV types. If high-risk HPV is detected, the sample is also tested for abnormal cervical cells (a process called reflex liquid-based cytology).
The test specifically identifies whether high-risk HPV types 16 and 18 are present (which carry the highest cancer risk and trigger immediate follow-up), or whether another oncogenic HPV type is present (which typically requires different management).
In terms of the physical procedure — for a clinician-collected test — it is essentially identical to the old Pap smear. A speculum is used to gently hold the vaginal walls apart, and a small brush collects a sample from the cervix. The procedure takes a few minutes. Some women find it mildly uncomfortable; most find it straightforward.
Self-Collection: What It Is and How It Works
As of 1 July 2022, all eligible women in Australia — not just those who are under-screened — can choose to self-collect their cervical screening sample. This is a significant and welcome change.
Self-collection involves using a small swab to collect a vaginal sample yourself, in private. The swab is then tested for HPV in the same way as a clinician-collected sample.
For many women, self-collection is a less daunting and more comfortable option. It is particularly valuable for women who have previously avoided screening due to discomfort, past trauma, cultural or religious reasons, disability, or simply not wanting a speculum examination.
How self-collection works in practice:
- You attend your GP (or nurse) appointment
- You are given a swab and instructions
- You collect the sample yourself in a private space (a consulting room, or the bathroom)
- You hand the sample to the GP or nurse for labelling and sending to the laboratory
Self-collection does not require a pelvic examination. It does not require a speculum. It can be done at any GP clinic or women’s health service.
One important note: self-collection tests only for the presence of HPV — it does not include the reflex cytology (cell check) component that a clinician-collected sample provides. If your self-collected sample tests positive for HPV, you will be asked to have a follow-up clinician-collected sample so that the cells can be examined. This is a normal part of the process, not a cause for immediate alarm.
Talk to your GP about whether self-collection is right for you.
What Do Your Cervical Screening Results Mean?
Results from your Cervical Screening Test fall into several categories. Your GP or the National Cancer Screening Register will contact you with your results and advise on next steps.
No HPV detected — all clear: Your test found no high-risk HPV. You are in the lowest risk category. Your next routine screening is in 5 years. You may receive an invitation from the National Cancer Screening Register when you are due.
HPV detected, not 16/18 (other oncogenic type): High-risk HPV has been detected, but it’s not the highest-risk types 16 or 18. The sample is tested for cell changes (cytology). Depending on the cytology result, you will either return for a follow-up test in 12 months or be referred to a specialist for colposcopy. This result does not mean you have cancer — most HPV infections clear without treatment.
HPV 16 and/or HPV 18 detected: These are the highest-risk types. Regardless of the cytology result, you will be referred for colposcopy — a closer examination of the cervix by a specialist gynaecologist or colposcopist. Again, this is not a cancer diagnosis. It means you need closer investigation.
Colposcopy: A colposcopy is a procedure where a specialist uses a magnifying instrument to examine the cervix more closely. A small biopsy (tissue sample) may be taken. Most women find it tolerable and similar in sensation to the screening test itself.
Treatment of abnormalities: If abnormal cells are found, they can typically be removed in a simple procedure. Treating early cell changes prevents them from progressing to cervical cancer.
What If You Are Overdue for Cervical Screening?
Many Australian women are overdue — either because they lost track of the 5-year interval, because the transition from the old 2-year Pap smear to the new program confused them about when they were next due, or because they’ve been avoiding it.
If you’re unsure of your screening history or when you’re next due, the National Cancer Screening Register holds records of cervical screening tests performed in Australia since the program’s inception. You can access your screening history by calling 1800 627 701 or asking your GP to check.
There is no “too overdue” to start again. If you haven’t been screened in years — or ever — a GP appointment is the right first step. Your GP will check your history, perform or arrange the screening test, and advise on follow-up based on your results and history.
HPV Vaccination and Cervical Screening: What You Need to Know
Australia has one of the world’s most successful HPV vaccination programs. The Gardasil 9 vaccine — which protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 — has been offered free to school-aged children (both girls and boys) since 2013.
This vaccination program is the reason Australia is on track to eliminate cervical cancer. But vaccination does not remove the need for cervical screening — for two reasons:
- Not all cancer-causing HPV types are covered by the vaccine
- Women who were vaccinated after they became sexually active may have already been exposed to HPV before vaccination
Cervical screening remains recommended for all eligible women regardless of vaccination status until guidelines explicitly advise otherwise.
What Symptoms Should Prompt an Immediate GP Visit?
Cervical screening detects problems before symptoms appear. But some symptoms require prompt GP assessment regardless of your screening history:
- Unusual or unexplained vaginal bleeding — between periods, after sex, or after menopause
- Unusual vaginal discharge — particularly if it has changed in colour, smell, or consistency
- Pelvic pain that is new or unexplained
These symptoms do not mean you have cervical cancer — they have many possible causes — but they should always be investigated by a GP. Do not wait until your next scheduled screening if you have any of these symptoms.
Cervical Screening for People Who Have Had a Hysterectomy
Whether you need cervical screening after a hysterectomy depends on what type of hysterectomy you had:
Total hysterectomy (cervix removed): If your cervix was removed as part of the procedure, you do not need routine cervical screening. However, if you had a hysterectomy because of cervical cancer or a high-grade abnormality, your specialist may recommend ongoing vault screening (a similar test on the vaginal vault). Discuss this with your GP or specialist.
Subtotal or partial hysterectomy (cervix retained): If your cervix was not removed, cervical screening continues as normal.
If you’re unsure what type of hysterectomy you had, your GP can check your records and advise.
Where Can You Get a Cervical Screening Test in Sunshine, Melbourne?
Cervical screening is available at your GP clinic, women’s health centres, family planning clinics, and sexual health services. At Central Health Clinic in Sunshine, our GPs and practice nurses offer cervical screening appointments, including the self-collection option. The test is covered by Medicare and there is no out-of-pocket cost for eligible patients.
If you have questions about self-collection, your screening history, or what your results mean — our team can help. You don’t need to navigate this alone.
Frequently Asked Questions
Has the Pap smear been replaced in Australia? Yes. The two-yearly Pap smear was replaced on 1 December 2017 by the five-yearly HPV Cervical Screening Test (CST). The new test detects human papillomavirus — the virus that causes almost all cervical cancers — rather than looking directly for cell changes. It is more accurate than the Pap smear and requires less frequent testing.
How often do I need a cervical screening test in Australia? Every 5 years, for women and people with a cervix aged 25–74 who have ever had any sexual contact. If your result is normal (HPV not detected), your next test is due in 5 years. Some results require follow-up sooner than 5 years — your GP will advise.
Does the cervical screening test hurt? Most women find the test mildly uncomfortable rather than painful — similar to a routine gynaecological examination. Relaxing the muscles of the pelvic floor and taking slow, deep breaths during the test helps. If you find it painful, tell your GP or nurse — there are ways to make the experience more comfortable, including smaller speculums and the self-collection option.
Can I self-collect my cervical screening sample? Yes — as of 1 July 2022, all eligible women in Australia can choose to self-collect their cervical screening sample using a small vaginal swab, done in private. Self-collection detects HPV but does not include the cell check component. If your self-collected sample is HPV positive, you’ll be asked for a follow-up clinician-collected sample. Talk to your GP about whether self-collection suits you.
What happens if my cervical screening test is positive? A positive HPV result does not mean you have cancer. It means high-risk HPV has been detected. Depending on which HPV type is found and the results of cell testing, you may need a follow-up test in 12 months or a referral for colposcopy — a closer examination of the cervix. Most HPV infections clear naturally, and most abnormal cell changes can be successfully treated before they develop into cancer.
I had the HPV vaccine — do I still need cervical screening? Yes. The HPV vaccine (Gardasil 9) provides strong protection against the most common cancer-causing HPV types but does not protect against all of them. Cervical screening remains recommended for all eligible women regardless of vaccination status.
The cervical screening test is one of the most effective cancer prevention tools available in Australian healthcare. It is safe, Medicare-funded, only needed every 5 years, and now available as a self-collection option for women who prefer it.
Australia’s cervical cancer rates have already halved since screening began. We now have a genuine opportunity to eliminate cervical cancer as a public health issue — but only if eligible women actually get screened.
If you’re due, overdue, or unsure — book an appointment. It takes less than 15 minutes and could save your life.
