The changes resulted from the passing of the Health (National Cervical Screening Programme) Amendment Act (2004). With the passage of the Act, the current section 74A of the Health Act was replaced with a new Part 4A.
A key purpose of the law change was to improve the operation and evaluation of the National Cervical Screening Programme (NCSP), to ensure its safety and effectiveness for women. The Act sets out objectives for the NCSP and provides for the appointment of experts (called evaluators) to assess the performance and safety of the programme by ensuring they have access to key information.
Key points from the legislation:
- Responsibilities to inform women are clearly outlined.
- All cervical results are sent by the laboratory to the NCSP.
- Results are entered onto the NCSP-Register and all women are enrolled unless a woman withdraws from the programme in writing.
- A full screening record must be kept on the programme so there is no longer the ability to ‘opt off’ individual results. A woman is either enrolled or has withdrawn herself from the programme.
- Programme evaluators are able to access other personal health records relevant to that woman. This can be done for the purposes of evaluation for any woman who develops cervical cancer regardless of whether or not they are enrolled in the programme. A smear taker is able to oversee an evaluator when accessing personal health records.
- The Act allows for the prescribing of standards which may be enforced if required.
HPV testing of cervical specimens - legislative requirements
There has been an increase in clinicians requesting human papillomavirus (HPV) tests when managing women with an abnormal cervical result or history therefore it is timely to remind clinicians of their responsibilities under Part 4A of the Health Act 1956.
Clinicians requesting HPV tests on all specimens with a cervical component, obtained either as part of a screening or diagnostic procedure or during a surgical procedure, are reminded that under Part 4A of the Health Act 1956 Section 112N laboratories are required to forward the results of these tests to the NCSP.
Additionally, under Section 112L and 112M, persons taking specimens for screening tests and persons performing colposcopic procedures have a duty to explain the procedure and to provide information to the woman regarding the NCSP and NCSP-Register, to the extent that is reasonable in the circumstances. This explanation includes who has access to information on the NCSP-Register and the uses to which that information may be put. Smear takers and colposcopists therefore need to advise women that the laboratory sends all cervical results, including HPV test results, to the programme and these are entered onto the NCSP-Register. All women are automatically enrolled unless they formally withdraw.
Data on the NCSP-Register is regularly analysed and evaluated to improve the NCSP and further inform best practice for the management of women in the NCSP.
In this section
Legislation requires regular, independent reviews of the NCSP to be undertaken. The second such review was prepared in late 2014 and took place in the first half of 2015.
The Ministerial Inquiry into the under-reporting of cervical smear abnormalities in Gisborne (the Inquiry) was charged with finding the reasons for the apparently high under-reporting of abnormal smears in the Tairawhiti region, and whether there was evidence of wider systemic issues.
Anyone wishing to use Māori women’s cervical screening data must apply to the National Kaitiaki Group for permission. The group: considers applications for approval to disclose, use, or publish protected information responds to the requests for data release as soon as reasonably practicable after receiving the request grants approval for such disclosure, use or publication in appropriate cases.