Requesting screening and follow-up under the renewed National Cervical Screening Program
From the 1st of December 2017, a new Cervical Screening Test every five years
will replace the existing two yearly Pap test. People will be due for their first
Cervical Screening Test when they would have been due for their next Pap test.
Health care providers will still perform a vaginal speculum examination and take
a cervical sample, but the sample medium is liquid based and will be tested for
the presence of HPV. If HPV is detected the laboratory will automatically
conduct a cytology test. This means that there will be a change to the way
pathology for cervical and vaginal samples is requested and processed.
The current Pap test will no longer be covered under the Medicare Benefits
Schedule (MBS), which means that if you write 'Pap test' or 'smear' on the pathology
request form your patient may be charged. From the 1st of December will be
increasing the MBS item numbers from 4 to 7. This is to reflect the different
pathways patients will now take through the National Cervical Screening Program,
in line with the new management guidelines. The reason we've had to
increase to 7 MBS item numbers is because the same material can be used
for screening or diagnosis and it has a very different pathway in the laboratory
depending on the patient's previous history. This sounds more complicated but
it really just reflects a diversity of patients that come to our service and a
better understanding of who they are and what their needs will be in this new
system. To help us choose the most appropriate MBS item number from the 7,
we really need quite a comprehensive history, particularly if the patient has
been immunocompromised, if they've had previous surgery such as hysterectomy, or
if they've had symptoms such as spotting PV bleeding or any sort of pain and
that information helps us decide in the laboratory what sort of pathway the
material will take. Other information that will be relevant is when the
patient was last screened for example. has there been any previous abnormality
even if it was some time ago and what are the symptoms present in your patient,
if any? The more information you put on the pathology request form will ensure
that the correct test is conducted on your patient's sample. A table containing
key information, including what to write on a pathology request form, has been
developed to support both providers and pathologists. Most providers should have
received a package in the mail from the chief medical officer. Included in this
package was a poster-sized copy of a table titled 'Pathology Test Guide for
Cervical and Vaginal Testing' along with a guide for health care providers
summarising the key changes associated with the renewal of the program. At the
back of this guide is a handy fold-out version of the table for your reference.
Extra copies can be ordered or downloaded through the National Cervical
Screening Program. Patients aged 25 to 74 years of age should be offered the new
Cervical Screening Test when they're due for their Pap test, which is usually two
years after their last negative test. Patients who are undergoing clinical
management for a previous abnormal result of treatment shall be offered the
new test when they're due for clinical follow-up. It's important to note,
symptomatic patients can be tested at any age. The renewed program will be
supported by a new National Cancer Screening Register that will send
invitations and reminder letters on behalf of the National Cervical
Screening Program. There's going to be a change in the way that patients opt out
of the register. No longer can you use the information on the pathology form to
opt patients out. It must come from the patient's themselves, through a
healthcare provider or a patient representative to the 1-800 number
directly. Importantly, if people do change their mind, patients can opt back into
the Register on that same number. We recognise that gathering all this
information in a very short potentially emotionally-charged time is very
difficult, so we will be happy to have conversations with general practitioners
and womens' health providers in the early phases in order to gather this
complete comprehensive list of clinical data.
National Cervical Screening Program www.cancerscreening.gov.au/cervical Phone: 13 15 56