Cervical Screening Guidelines

The National Cervical Screening Programme (NCSP) will be releasing new guidelines for health care providers. These will replace the current Guidelines for the management of women with abnormal cervical smears (1999).

The guidelines will be implemented from 29 September 2008 along with the new NCSP Register, which has been developed to track women according to the new guidelines.

The guidelines have been developed through a process of review of evidence and consensus decision making by multi-disciplinary groups of health professionals and consumer representatives.

Since the previous guidelines were published, understanding of the role of human papillomavirus infection in cervical cancer has advanced considerably and the results of some significant international studies have become available. Based on this evidence, the key changes will be for women with cytological low grade squamous cell changes (ASCUS/LSIL) ie:

Cervical Smear Report	Guidelines for the Management of Women with Abnormal Cervical Smears (2008)	Action
ASCUS/LSIL	Women aged 20 - 29 years with no abnormal smear reports within the last 5 years	Repeat cervical smear in 12 months
	Women aged 30 years and over with one (or more) normal smear reports in the last 5 years*	Repeat cervical smear in 12 months
	Women aged 30 years and over who have not had a smear in the last 5 years*	Offered either a repeat smear within 6 months or a referral to colposcopy

* Until 1 July 2009 - HrHPV testing as from 1 July 2009

Tests for detection of high risk types of human papillomavirus (HPV) have recently become available. There is good evidence that properly applied HPV testing can play an effective role in the management of some groups of women, specifically:

for the triage of women 30 years and over with low grade smear results
following treatment for a high grade lesion
to assist in the management of ‘discordant’ colposcopy/cytology results.

For logistical reasons, HPV testing will not form part of the new guidelines until 1 July 2009.

However, the NCSP has developed best practice guidance on the use of HPV testing. An information and training programme will be run for practitioners prior to the introduction of HPV testing.

NCSP Best Practice Guidance on HPV Testing

HPV Testing Guidance Flow Charts

More detailed information on the new guidelines will be disseminated to health practitioners and will become available on this site. This will include:

a management summary table
flowcharts
the final guideline document
key messages for women and health practitioners on HPV testing.

For queries about the guidelines contact Diane Casey, NCSP Programme Manager: diane_casey@moh.govt.nz ph. (09) 580 9039 or Hazel Lewis, Clinical Leader, NCSP: hazel_lewis@moh.govt.nz ph. (04) 816 4343.

Cervical Screening Guidelines

Cervical Screening Guidelines

Cervical Smear Report

Guidelines for the Management of Women with Abnormal Cervical Smears (2008)

Action