On the 1st December, 2017, Australia introduced a Renewed Cervical Screening Program. The conventional Pap smear was replaced as the screening test with molecular testing for Human Papilloma Virus (HPV). The change was largely mandated by the development of new technologies and the highly successful national vaccination program for HPV. Because of the increased sensitivity of HPV testing, screening is to commence at age 25 and take place at 5 yearly intervals. Because of this increased sensitivity, triaging of positive results by Cytology and Colposcopy is necessary.
As part of the new program, testing for symptomatic patients has also been included. Any woman with certain symptoms or signs at any age can have a test for HPV and in some circumstances, a co-test for HPV and cytology. Managing these symptomatic women can be complex and management algorithms present in the new treatment guidelines are at times confusing.
These changes may affect all Gynaecologists with increased referrals for abnormal bleeding and the more complex management algorithms need to be understood.
Specific case presentations will be briefly presented to help, discuss and clarify some of these issues.