Clinical Practice Guidelines for Cervical Screening in New Zealand

The updated Clinical Practice Guidelines for Cervical Screening in New Zealand 2020 outline the management of women with abnormal cervical screening results and incorporate key National Cervical Screening Programme (NCSP) policies related to cervical screening, and colposcopy assessment and treatment services.

A separate document with the flowcharts is available as a useful reference.

• Clinical Practice Guidelines for Cervical Screening in New Zealand 2020 (pdf, 2 MB)
• Clinical Practice Guidelines for Cervical Screening in New Zealand 2020 (docx, 3 MB)
• Flowcharts (docx, 2 MB)
• Flowcharts (pdf, 1 MB)

Other useful resources:

• Summary of indications for HPV testing (Word, 339 KB)
• Summary of indications for HPV testing (PDF, 171 KB)
• Guideline 17 – the management of women who have had a hysterectomy (Word, 21 KB)
• Guideline 17 – the management of women who have had a hysterectomy (PDF, 18 KB)
• Total hysterectomy NCSP Register advice form (Word, 66 KB)

The key changes in the document are:

1. in November 2019 the NCSP raised the recommended commencement age for screening to 25 years for any person with a cervix or vagina who has ever been sexually active. People aged 20–25 years who have already commenced screening, including those with abnormal cytology, will be recalled and managed according to these guidelines.
2. a new section on abnormal bleeding that does not wholly relate to the cervical screening pathway has been included to assist medical practitioners in primary care with assessment, management and referral decisions. The most important message from this section is that symptomatic people need to be examined.
3. a new recommendation that people aged 70 years and older who were unscreened or under-screened prior to age 70 have two consecutive normal cytology samples (taken 12 months apart) before ceasing cytology screening. Unscreened and under-screened people in this age group are at increased risk of cervical cancer because of potential undetected cervical lesions.
4. a change to the recommendation for follow-up after successful treatment for high-grade squamous disease is discharge from colposcopy to primary care for a test of cure. Cytology and hrHPV testing should be performed 6 months post-treatment, with a repeat co-test (cytology and hrHPV testing) 12 months later to complete a test of cure. Where there are clinical concerns, colposcopy with hrHPV and cytology testing at 6 months post-treatment is recommended.

The HPV testing area in section 3 has been reviewed and relevant HPV testing information and flowcharts have been incorporated into the main document.

Other areas have been updated where further evidence and clinical experience have suggested that changes are required.

Please send any comments or queries about the guidelines to the National Cervical Screening Programme at [email protected].

Hard copies (limits on the number ordered) are available from our Publications Centre on (04) 496 2277, Ministry of Health Publications, Sector Operations Contact Centre, Private Bag 3015, Whanganui 4540, or email [email protected] (link sends e-mail). Please quote HP4656 when ordering this resource.