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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 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:
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.