Frequently asked questions

On this page you will find answers to frequently asked questions about proposed changes to the cervical screening test.

Why is the screening test changing?

What will people notice when HPV primary screening is introduced?

How is the new testing different from the current cervical test?

Can people self-test now?

What is the relationship between HPV and cervical cancer?

Why is HPV immunisation important?

What if I’ve had the HPV vaccine, should I still be screened?

What should I do if I am due for screening?

What will be the next steps?

 

Why is the screening test changing?

HPV causes over 99 percent of cervical cancers. HPV primary screening is a more effective test for identifying the risk of developing abnormal cell changes that may lead to cervical cancer.

The new HPV screening test, including the option for self-testing, will encourage more people with a cervix or vagina to take part in screening and will help reduce inequities for Māori and Pacific population groups/people. 

What will people notice when HPV primary screening is introduced?

There will be some changes:

The current cervical screening approach involves a clinician taking the sample using a speculum. In the new programme, the option of HPV self-testing with a vaginal swab will be available. This is expected to be more acceptable to participants. A clinician can also take the swab.

If the HPV test is positive, follow-up will be needed. This might include:

  • a speculum exam to look at the cervix and check the cells
  • a colposcopy, a procedure done in outpatients, where a specialist can inspect the cervix through magnification and may take a biopsy or remove an area of concern.

When the programme starts, people will need to see their health care provider for the HPV test, even when self-testing. The process will be that a doctor, nurse or other health care worker will explain how to do the test, and the person takes the test in a private area of the clinic. The health care provider may also arrange for the tests to be done off site, for example, at home, or in a non-clinical setting in the community. The clinic will be responsible for getting the sample to the laboratory.

In the future, the Ministry of Health will be looking at ways to make screening more accessible, which could include mailing-out self-testing kits if they are found to work safely and well.

How is the new testing different from the current cervical test?

Currently the initial cervical screening test is cytology (which checks on the cells in the cervix or vagina) and HPV testing is available in certain clinical situations. The new test involves HPV as the first test, with cytology to follow if the HPV test is positive.

The current cervical screening test requires a speculum examination. The option of the person taking the HPV sample themselves with a swab (self-testing) will be available with the new programme. The health professional can also take the sample.

The HPV test identifies if the HPV virus is present, which over time could lead to the development of pre-cancerous cells changes in the cervix or vagina.

People with a negative HPV test are at very low risk of developing abnormal cells that may lead to cervical cancer within the next five years. This means that the time between cervical screening tests can safely be increased from three to five years.

Can people self-test now?

The change to new HPV primary screening programme will be implemented from July 2023.

The current cytology screening programme remains a high-quality programme by international standards and is effective at preventing many cases of cervical cancer.

During the transition to the new programme it is important that people continue with cervical cytology screening and not wait for the programme change in 2023.

What is the relationship between HPV and cervical cancer?

Almost all cervical cancer is caused by human papillomavirus (HPV), which is spread by sexual activity. Eighty percent of people who have been sexually active will have an HPV infection at some point in their lives.

There are many types of HPV. Most HPV infections will clear up by themselves.

Only a few types of HPV will lead to abnormal, pre-cancerous cells that could progress to cancer.

Cervical cancer usually takes many years to develop. Any abnormal cells can be found and treated to stop them from becoming cancer.

Why is HPV immunisation important?

Persistent HPV infection is responsible for almost all cases of cervical cancer.

The vaccine is very effective in preventing infection from the nine types of HPV responsible for around 90 percent of the cancers caused by HPV.

Not all the HPV types that cause cervical cancer are in the vaccine, so people who have been vaccinated need to continue with regular cervical screening.

HPV immunisation is delivered through school-based immunisation programmes and is also available through your family doctor. HPV immunisation is free for everyone aged 9–26 years (inclusive), including boys and young men.

Please visit the Ministry’s HPV immunisation webpage for more information.

What if I’ve had the HPV vaccine, should I still be screened?

The HPV vaccine is highly effective, but not all the HPV types that cause cervical cancer are in the vaccine, which means it is still very important to have cervical screening to minimise the risk of cervical cancer.

Combining HPV immunisation with regular cervical screening is the most effective way you can protect yourself against cervical cancer.

What should I do if I am due for screening?

Regular cervical screening is the most effective way you can protect yourself against cervical cancer.

The current screening programme continues to be safe and effective, and it is important that people keep having their regular cervical screening tests, and not wait for the change to HPV primary screening in 2023.

People who are nervous or have concerns can talk to their health care provider. They will be able to help find ways to make screening more comfortable.

If you are concerned about symptoms that could be cervical cancer, see your doctor as soon as possible.

Symptoms to watch out for include unusual bleeding between periods, pain or bleeding during or after sex, a persistent discharge, and vaginal bleeding after menopause.

Visit Time to Screen for more information.

What will be the next steps?

A consultation on the inclusion of the self-testing component in the guidelines and referral pathways was undertaken in early 2021. A summary of consultation feedback will be available on this website.

The programme change will occur in July 2023.

Page last updated: 20 July 2021