Cervical screening

Cervical screening

Cervical Screening remains your best protection against cervical cancer. In Australia, since 1991, Australian women and people with a cervix have been able to participate in cervical screening through the National Cervical Screening Program

The program changed on December 1, 2017. The Pap test (or Pap smear) has been replaced by the HPV Test, or Cervical Screening Test (also referred to as CST). These changes are a result of new evidence and better technology to help improve early detection of cervical cancer and save lives.

The new Cervical Screening Test detects human papillomavirus (HPV). The current guidelines recommend that every woman and person with a cervix from the ages of 25-74 who has ever had sexual contact should have a Cervical Screening Test every five years even if you have:

  • had the HPV vaccine
  • only had one sexual partner
  • not been sexually active for a long time
  • been in a long-term monogamous relationship
  • never had sex with a person who has a penis
  • been through menopause

* If you’ve had a hysterectomy, check with your doctor about your screening needs. Depending on the type of hysterectomy and your medical and screening history, you may need to continue to undertake a type of screening.

You have two options for cervical screening:

  1. Self-Collection
  2. Practitioner Collection

Comfort checklist

The Comfort Checklist is a tool to help you prepare for your cervical screening test so you can have a positive screening experience. Developed by ACCF and a panel of experts, the Comfort Checklist is designed to overcome some of the barriers that prevent women and people with a cervix from participating in preventive screening.  

The new and improved versions are available, for

  • women and people with a cervix
  • health professionals


One third of Australians are not participating in cervical screening as frequently as recommended. This means they are overdue or have never presented for screening. If we want to see cervical cancer eliminated by 2035, we need these cervical screening numbers to rise.

Please share this resource with your friends to help increase cervical screening rates!

“We hope this Checklist will help Australian women and people with a cervix feel more at ease during their cervical screening experience and be more empowered to take charge of their health. We thank our contributors, especially Queensland Health for their input and guidance in the development of this important initiative to reduce the incidence of cervical cancer in Australia.”
Liz Ham
Health Promotion Manager, Australian Cervical Cancer Foundation


Why was the change from the Pap Test to the Cervical Screening Test made?

The Cervical Screening Test (CST) introduced in 2017 is more effective at detecting the human papillomavirus (HPV) that causes cervical abnormalities, at an earlier stage. Prior to 2017, the Pap test (or Pap smear) was utilised. It looked for cell changes in the cervix, whereas the Cervical Screening Test looks for the human papillomavirus (HPV) which can lead to cell changes in the cervix. 

Cervical cancer is rare, and it usually takes 10 years for abnormalities caused by HPV to develop into cervical cancer. The new CST is a more accurate, effective and safe test to have every five years instead of the two-yearly Pap test. 

Aggressive, fast-growing cancers are very rare and usually diagnosed when women see a doctor after noticing symptoms. All screening programs are designed for women without symptoms. 

Women of any age who have symptoms (including pain or abnormal vaginal bleeding or discharge) should see their doctor immediately.

How does the Cervical Screening Test work?

The Cervical Screening Test (CST) detects human papillomavirus (HPV) infection, which is the first step in developing cervical cancer. Persistent HPV infections can cause abnormal cell changes that may lead to cervical cancer. However, this usually takes a long time, often more than 10 years from initial HPV infection. While the old Pap test (or Pap smear) could detect abnormal cell changes, the Cervical Screening Test will detect the persistent HPV infection that causes the abnormal cell changes, prior to the development of cancer. 

If you choose for your health practitioner to conduct the screening, the procedure for collecting the sample for HPV testing is the same as the procedure for having a Pap smear. A doctor or nurse takes a small sample of cells from the woman’s cervix.

If you choose self-collection, you will be given a self-collection kit and instructed on how to collect cells from your vagina. The samples collected are then sent away to a laboratory to be examined.

How does self-collection cervical screening work?

A self-collected sample is taken from the vagina and is checked for human papillomavirus (HPV). You will need to visit your doctor or nurse to get the kit and will then take your sample in a private space, such as a bathroom. All you need to do is insert a swab a few centimetres into your vagina and rotate it for 20 to 30 seconds. Learn how to take your own sample and find more information at Self-collection for the Cervical Screening Test.

Where can I go to have a cervical screening test?

To make an appointment with a health professional to have a Cervical Screening Test, you can contact:

  • your general practitioner or practice nurse
  • a community or women’s health centre
  • a family planning or sexual health clinic
  • a women’s health nurse
  • an Aboriginal Medical Service
How do I prepare for cervical screening?
  • Read information on cervical screening so you know what to expect. Your health professional can collect your sample, or you can collect your own sample. Both choices are accurate and safe. 
  • If you have been through menopause, you might like to ask about using an oestrogen cream in your vagina in the week before your appointment to make the test more comfortable.
  • Wear loose comfortable clothing – you may need to remove clothing from the waist down.
  • Empty your bladder before you arrive at the clinic or ask to use the toilet when you arrive.
  • Try to stay as relaxed as possible – this will help minimise any discomfort. For example, try to take some long slow and deep breaths. 
  • Make a list of any questions you have for the doctor.
What to expect from your health professional at your cervical screening?

A Cervical Screening Test (CST) is a relatively simple procedure that only takes a few minutes and should not be painful. Your screening experience should include:

  • An option to have a support person present (e.g., relative/friend/clinic nurse).
  • The choice to have your health professional collect your sample or to collect your own sample.
  • An easy-to-understand explanation of what to expect in your screening choice.
  • Questions from your health professional about your period and contraception methods.
  • Answers to any questions you have about the screening, appearance of your reproductive organs, when results will be available, how the results will be communicated with you and any follow up required.
What to expect from a health professional collected cervical screening?
  • Privacy to undress and dress and a sheet to drape across your stomach and thighs.
  • Sterilised medical instruments (at a comfortable temperature) to take a sample.
  • Easy to understand instructions during the procedure and reassurance. You can ask the health professional questions and ask them to stop at any time.
  • When you are ready, your health professional will:
    • ask you to bend your knees so they can insert an instrument called a speculum into your vagina. The speculum can be plastic or metal and holds the walls of the vagina open, allowing a clear view of the cervix. This part of the exam can feel slightly uncomfortable or awkward, as there may be some pressure on your pelvic area, but it shouldn’t be painful. If you do feel any pain let your health professional know and they can adjust the speculum. You can insert the speculum yourself.
    • use a small brush to gently collect a swab from the cervix. The cells collected on the swab are then sent off to a lab for examination to check for the presence of human papillomavirus (HPV).
What to expect from self-collection cervical screening?
  • A private place to take the sample.
  • Clear instructions about how to do the test and help if you need it.
  • When taking the sample:
    • make sure you know which end of the swab can be held and which end is for taking the sample before you open the package. If you are unsure which end is which, ask your healthcare provider for advice.
    • take off your pants to make it as easy as possible to take the sample,
    • make sure your hands are clean and dry, 
    • get yourself in a comfortable position,
    • use your free hand to move the skin folds at the entrance of your vagina, 
    • gently insert the swab, taking end of the swab into your vagina a few centimetres,
    • rotate the swab gently for 20-30 seconds (in any direction). This may feel a bit uncomfortable but should not hurt.
    • gently remove the swab from your vagina,
    • place the swab back into the packaging with the end that took the sample going in first,
    • screw the cap back on,
    • get dressed and return the package to your healthcare professional.
Should I check with a medical professional between screenings?

Your GP or health professional should let you know if you need to have them more regularly. It is also important to check with a medical professional if between tests you have any unusual symptoms such as:

  • unusual bleeding – after sex or between your usual periods
  • unusual changes to the colour, smell or amount of vaginal discharge
  • pain during or after sexual activity
  • warts or other growths, lumps, or sores on your genitals, anus or in the mouth or throat
  • pain or discomfort going to the toilet
  • painful abdominal cramps or lower back pain – (NB these symptoms are very common for people with a cervix during their period, but if cramping is extremely painful or persistent, you should chat with your doctor.)


*Please note that these symptoms are very general and may not indicate cervical cancer.

When will my cervical screening test results be available?

The results of your Cervical Screening Test will usually be available within two weeks. You can either schedule a follow up appointment or call your health professional for the results. Your results will also be automatically sent to the National Cancer Screening Register that keeps a record of your screening history and contact you by post if you are overdue for your next test. If you do not wish for this to occur speak to your provider when you have your Cervical Screening Test. You can find out what different results mean at Understanding your Cervical Screening Test results.

I have specific health needs: how can these affect Cervical Screening Test?

It is important to see a health professional regarding specific health needs such as information on pregnancy, early sexual intercourse, sexual abuse, immunodeficiency, and DES exposure.

I am under 25. When should I have a cervical screening test?

All women and people with a cervix commence cervical screening at 25 years of age. This starting point for cervical screening has been decided upon after years of research that has found:

  • Cervical cancer in people under the age of 25 is rare.
  • Most people under 25 years have been vaccinated for HPV and have robust immune systems that will usually clear the infection quickly and without treatment.
  • Research has shown that screening people under the age of 25 does not reduce the incidence of cervical cancer in that age group
  • Commencing screening at age 25 will reduce the investigation and treatment of common cervical abnormalities that would usually resolve by themselves in women and people with a cervix under the age of 25. This is because it can take 10 to 15 years for a persistent HPV infection to develop into cervical cancer.

Medicare does not cover routine cervical screening for women and people with a cervix under 25 years of age but if you are experiencing symptoms such as unusual bleeding, unusual discharge and pain, please make an appointment with your healthcare provider immediately.

For more information, please visit www.cancerscreening.gov.au/cervical or discuss with your GP what these changes mean for you.

When should I stop having Cervical Screening Tests?

Cervical Screening Tests are recommended every 5 years from the age of 25-74, unless your doctor advises otherwise. If you are 70 years or over and have had regular Cervical Screening Tests, you will be recommended to have an exit HPV Test, but you can continue to undertake cervical screening if you would like to. If you are over 70 years old and have never had a Cervical Screening Test, you can make an appointment to be screened.

Will cervical screening prevent all cervical cancers?

There are some rare neuroendocrine cervical cancers that are not caused by HPV. This means they won’t be detected through routine cervical screening tests.

I am HPV vaccinated, so why do I need to have cervical screening tests?

The current HPV vaccine provides protection against about 90% of cervical cancers so it is important that even if you are vaccinated, you are also screened for cervical cancer as you do not have 100% protection.

LGBTQI and cervical screening

Cervical cancer affects lesbian, bisexual, queer and pansexual women. Cervical cancer also affects transmen and non-binary people with a cervix. The National Cervical Screening Program (NCSP) in Australia is available to all people with a cervix between the ages of 25 and 74 who have ever been sexually active. Here we look to address any queries about cervical screening for the LGBTQI community.

ACONs Cervical Screening campaign, Own It, empowers all women and people with a cervix to own their Cervical Screening Test. See the video about ACON’s campaign. 

What if I have never had sex with a man or person with a penis?

Human papillomavirus (HPV), the virus that causes almost all cervical cancers, can be transmitted by any kind of sexual contact. Transmission does not require a penis or penetrative sex to be involved. Transmission can occur no matter how you identify. As HPV has no symptoms and tests are not conducted on people with a cervix until they are 25 years old, there is always the possibility that a sexual partner could have contracted the virus and passed it on to you without your or their knowledge. HPV is very common so even if you have only had one sexual partner, you need to be screened.

How do I find the best doctor to meet my needs?

It is important that you find a medical professional who you feel comfortable with to discuss your cervical screening and other health needs. Your friends may have suggestions, or the following links can help you find a provider in your area. 

The Australian Lesbian Medical Association (ALMA) compiles an up to date list of doctors and mental health professionals who are recommended by lesbian and bisexual women. 

The Gender Affirming Doctor List from ACON’s TransHub website provides information for trans and gender diverse people in NSW.  

The Australian Professional Association for Trans Health (AusPATH), is Australia’s peak body for professionals involved in the health, rights and well-being of trans, gender diverse and non-binary people. They provide a list of health service providers

By law, health professionals must maintain privacy and confidentiality. If you are happy for your records to be shared with other health professionals, they can be added to your profile with My Health Record

Where can I get further information to prepare?
  • Review information on Cervical Screening so you know what to expect. ACON has a great resource on Helping you through the test  
  • If you are nervous about the screening procedure, then write down any questions or concerns you have that you can ask or give to the health professional.
What can I do if I feel uncomfortable or I am being discriminated against during screening?

If you are feeling uncomfortable during the screening process, you can ask to stop or pause the procedure. You can ask any questions that may overcome this discomfort and enable the screening to continue, or you can leave at any time you wish.

You can take a support person with you to your screening appointment. Discuss your concerns about the screening and how they can best support you. Taking a list of questions with you to the appointment can help you check all your concerns have been addressed.

A person cannot be discriminated against due to their gender identity, sexual orientation or lawful sexual activity (Equal Opportunity Act 2010). If you feel discriminated against, sexually harassed, victimised or vilified, you or someone on your behalf can make a complaint to the Human Rights Commission. Discussion with a friend or support person can be helpful if you do not wish to make a complaint.