Please note there are important changes to the National Cervical Screening Program (NCSP) Clinical Guidelines when a woman has an intermediate risk result.

Revised clinical guidelines recommend a second follow-up HPV test for women at intermediate risk instead of referral for colposcopy at the time of their 12-month follow-up intermediate risk result.

The revised Clinical Guidelines, introduced in February 2021, confirm that it is safe for patients with a 12-month follow-up HPV (not 16/18) result and negative liquid-based cytology (LBC), or possible low-grade squamous intraepithelial lesion (pLSIL) or LSIL (intermediate risk result), to have a second follow-up HPV test in a further 12 months after their first follow-up HPV test, instead of referral to colposcopy.

Note the exclusion criteria below for patients at intermediate risk at their 12-month follow-up test after an intermediate risk cervical screening test result.

For women who may be at higher risk of a high-grade abnormality, a referral for colposcopy is recommended if HPV (any type) is detected at the first 12-month follow-up HPV test, regardless of the result of reflex LBC.

This includes any of the following groups:

• Women who are 2 or more years overdue for screening at the time of the initial cervical screening test*
• Women who identify as Aboriginal and/or Torres Strait Islander
• Women aged 50 years or older

*Initial screening relates to the first cervical screening test undertaken which determined the patient met criteria for the intermediate risk screening pathway

Patients who meet the abovementioned exclusion criteria should be referred for colposcopic evaluation at the time of their 12-month follow up intermediate risk result.

While these new recommendations came into effect from 1 February 2021, reminders are being sent to healthcare providers of this important change for patients on the intermediate risk pathway. 

Please contact NCSPCommittees@health.gov.au if you have any questions regarding the clinical management of women at intermediate risk within the NCSP.