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Self-sampling HPV testing versus mainstream cervical screening and HPV testing

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A comprehensive review of Australia’s National Cervical Screening Program (NCSP), the Renewal, has been undertaken over the past few years.1 This review recommended a number of changes, including that human papillomavirus (HPV) testing replace conventional cytology (ie, Pap tests) as the primary screening test, with 5-yearly screening commencing at age 25. The proposals have been endorsed by the Medical Services Advisory Committee (MSAC).2

The Renewal deliberations also considered the question of the recruitment of women who had never been screened or who were underscreened, a significant concern because it has been estimated that 80% of cervical cancers are diagnosed in these women.1 One proposed solution is to offer a separate self-sampling HPV testing pathway, as studies, both in Australia 3 and internationally,4 have shown self-sampling to increase recruitment and to be advantageous in underscreened women. The Renewal proposal is that the self-sampling option be organised by a clinician who also offers routine screening. It would be offered to women who have not been screened during the previous 6 years, or who have never been screened and have declined to participate in the mainstream screening pathway. The sample would be taken by the patient, possibly in the clinic, and sent…