NATIONAL CERVICAL SCREENING PROGRAM GUIDELINES
GUIDANCE FOR MANAGING NCSP PARTICIPANTS DURING THE COVID-19 PANDEMIC This guidance from the Australian Department of Health will assist clinician decision-making on cervical screening appointments including deferral and rescheduling, depending on individual patient circumstances. It is important to continue to offer routine screening and follow up wherever possible. The National Cancer Screening Register (NCSR) continues to support the NCSP by sending reminder letters and following-up patients who are overdue for the recommended further investigation.
PATIENTS PRESENTING FOR CERVICAL SCREENING OR WITH SYMPTOMS 1. Symptomatic:
Any individuals who are experiencing symptoms of cervical cancer (pain, abnormal bleeding, persistent unusual vaginal discharge) should be clinically assessed and investigated according to the Clinical Management Guidelines.
2. New Screener - Recently turned 25:
Individuals turning 25 in 2020 will be sent an invitation to start screening. These individuals were offered HPV vaccination at school, so have substantial protection either through direct HPV vaccination or through herd immunity. Rescheduling screening appointments in this group for 3-6 months is considered to be low risk.
3. Routine Screeners:
Anyone who has screened since 1 December 2017 and had a negative HPV screening result will not be due again until at least 2022.
www.vcspathology.org.au
4. Overdue or Never-screened:
3. Test of Cure after treatment for HSIL (CIN2/3):
If a patient requests a Cervical Screening Test (CST) and it has been more than two years since their last Pap Screen, they are overdue for screening It is recommended to screen these patients as they present. Patients 30 years of age or over who have never participated in screening should be offered a CST without delay. These patients may be offered self-collection; see below for more information.
FOLLOW-UP TESTING AND INVESTIGATION
If you decide to defer your patient’s CST or follow-up, the NCSR can be notified of your decision to reschedule and the deferral period, to prevent further overdue reminders from the NCSR. Your practice staff can do this by calling the NCSR cervical contact centre on 1800 627 701.
SELF-COLLECTION
1. Intermediate risk – 12 month follow up of HPV non 16/18 positive (with negative or low grade cytology):
Patients who are on the Test of Cure pathway should continue with that testing and be seen on time wherever possible.
Retest patients at the recommended time wherever possible. A delay of 3 to 6 months may be acceptable, delays for longer than 6 months are discouraged.
2. Management of higher risk results (HPV 16/18 positive, or non 16/18 HPV positive with possible high grade cytology or worse1):
Self-collection of a vaginal sample using a swab is available to people eligible to participate in cervical screening who are 30 years and over, and either have never screened or are two or more years overdue for screening (i.e. 4 years since last screen). Contact VCS Pathology on (03) 9250 0300 to discuss any issues with swab supply.
FURTHER INFORMATION
Patients with higher risk results should be referred • Check for NCSP updates at; to a specialist for further investigation without delay. http://www.cancerscreening.gov.au/internet/ Under the NCSP, all women with proven CIN2+ are screening/publishing.nsf/Content/cervical-screening-1 either Category 2 (urgent) or Category 1. All confirmed • More information on COVID-19 is available at lesions of CIN2+ should still be treated with urgency. health.gov.au or through the COVID-19 hotline Refer to http://www.cancerscreening.gov.au/internet on 1800 020 080. screening/publishing.nsf/Content/position-statement on-the-management-of-patients-during-the-covid- 19-pandemic.
1
includes HSIL, Cancer or glandular abnormality
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