HPV primary screening

The National Cervical Screening Programme (NCSP) is planning to change the first step in the screening pathway from liquid-based cytology screening to human papillomavirus (HPV) primary screening. A date is still to be decided.

Latest update: National Cervical Screening Programme – sector update August 2020

HPV primary screening means that a cervical screen sample is first tested for the presence of an HPV infection because almost all cervical cancer is caused by genital infection with HPV.

HPV infection is very common and about four out of five people have an HPV infection at some time in their lives. There are many different types of HPV, some of which are high-risk for the possibility of developing cancer, and some which are low-risk. For most women who develop an HPV infection, it will clear up naturally. High-risk types of HPV can cause cell changes in the cervix which, if not treated, can lead to cervical cancer.

The best way to protect against the HPV infection is to get immunised. The best way to protect against cervical cancer is to have the HPV immunisation and to attend cervical screenings for early detection of abnormal cervical cells.

The International Agency for Research on Cancer and the World Health Organisation have endorsed HPV testing as the primary screening method for cervical cancer.

Several other countries are also changing to HPV primary screening, including England, Australia and the Netherlands.

The frequently asked questions contains more information about the change to HPV primary screening.

A technical references (Word, 30 KB) list has been created for those interested in reading more about HPV primary screening, including the latest research from around the world.

When planning the move to HPV primary screening in New Zealand, the Ministry of Health commissioned research using New Zealand and international data. That research shows that HPV primary screening will be more effective for women than the current cytology test.

The potential benefits of adopting HPV primary screening include:

  • decrease in cervical cancer incidence and mortality
  • better detection of risk of precancerous cervical cell changes
  • providing a more effective test for women who have had the HPV vaccine as well as those who have not
  • safe but less frequent screening (every five years rather than every three).

The NCSP also released a public consultation document on changing the primary cervical cancer screening test in September 2015.  

The consultation summary (Word, 366 KB) provides a concise overview of the consultation process, including highlights from the submissions, areas requiring further work and proposed next steps.

In October 2015, 13 consultation meetings, hui and fono were held with members of the public, community-based organisations and health professional groups. Individuals and organisations were invited to make a submission in response to the proposed changes and the NCSP received 87 submissions. 

Meetings notes (Word, 475 KB) are available from the 13 consultation meetings held around the country.

The raw submissions (Word, 1.6 MB) feature the complete text from the 87 submissions that were received from individuals, organisations and health professional groups. Personal information has been withheld when requested.

Guiding principles for the change to HPV primary screening are that the final approach should:

  • deliver a best-practice national cervical screening programme
  • make access to screening more equitable for women in all population groups
  • maintain and improve safety and quality of screening for enrolled women
  • maintain a skilled and competent workforce to deliver the national programme
  • have been established after consulting with a wide range of stakeholders so that there is a smooth transition to the new primary screening pathway
  • maintain and improve the NCSP-Register’s capability to support the programme.

Decisions will not be made in isolation: it is vital to engage the public and the health sector so that any changes are successful. Potential changes are being carefully thought through and are based on the best available evidence.

To support this project, the NCSP has asked for input from a wide range of New Zealand and Australian experts in epidemiology, cancer modelling, colposcopy, pathology, cytology, microbiology and primary care, as well as from Māori and Pacific community members. This input will continue as we work towards implementing HPV primary screening.

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Page last updated: 14 December 2017