Overview of the National Cervical Screening Program

The National Cervical Screening Program (NCSP) aims to reduce illness and deaths from cervical cancer by encouraging women to have regular cervical screening. The NCSP was established in 1991 as a joint initiative of the Australian and state and territory governments to provide better protection against cervical cancer. Renewal of the NCSP commenced in 2011 and culminated in the implementation of a new Program on 1 December 2017.

On 1 December 2017, Australia established a new cervical screening process based on recommendations by Australia’s independent Medical Services Advisory Committee (MSAC).

The new Cervical Screening Test has replaced the existing Pap test. MSAC recommended that the new screening test will be conducted every five years instead of every two for people aged 25 to 74 years.

Nearly all cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer is a rare outcome of persistent infection with oncogenic HPV types. The time from HPV infection to cervical cancer is usually 10 to 15 years. Cervical screening should focus on detecting HPV, in particular types 16 and 18 that have been associated with 70% to 80% of the cases in Australia. Evidence suggests that screening for HPV every five years is more effective than, and just as safe as, screening with a Pap test every two years.

The NCSP involves:

  • encouraging all eligible women to enter and remain in the screening program;
  • ensuring optimal quality of cervical screening with training for test providers (ie general practitioners, nurses, Aboriginal and Torres Strait Islander health workers and gynaecologists);
  • ensuring optimal quality of cervical screening reading through a quality assurance program for laboratories (ie RCPAQAP);
  • ensuring appropriate follow-up of abnormal cervical screening results through management guidelines;
  • encouraging women’s participation in the program by providing invitations and reminders to screen;
  • providing reminder systems to ensure adequate follow-up of women with screen-detected abnormalities; and
  • reporting on national performance measures and contributing to national cancer data.

In order to achieve these aims the NCSP relies upon the successful interactions of:

  • cervical screening providers including general practitioners and nurse providers as well as specialist medical practitioners including colposcopists and gynaecological oncologists;
  • pathology laboratories; and
  • the National Cancer Screening Register (NCSR).

Renewal and ongoing management of the National Cervical Screening Program (NCSP) requires the engagement and cooperation of numerous Commonwealth and state & territory government departments with input and advice from a range of healthcare professionals and other experts as well as feedback from a broad range of stakeholders. Governance of the transition process and the ongoing monitoring of the NCSP is provided by a number of groups and committees.

The following is a summary of the principal planning and governance bodies:

  • The Australian Government Department of Health (Health) provides overall policy direction and coordination, national data collection, quality control and monitoring and evaluation. Cervical screening services are largely provided in general practices with funding through the Medicare Benefits Schedule.
  • State and territory governments provide local oversight of the delivery of the program including health promotion activities, monitoring and program management.
  • Australian Health Ministers’ Advisory Council ( AHMAC ) - the advisory and support body to the Council of Australian Governments (COAG) Health Council which considers matters relating to the co-ordination of health services across the nation and is responsible for major policy decisions about the NCSP.
  • Standing Committee on Screening advises the Clinical Principal Committee (CPC) of the Australian Health Ministers Advisory Council (AHMAC) on national population based screening activities including overseeing the NCSP Renewal and the establishment of the National Cancer Screening Register.
  • Medical Services Advisory Committee (MSAC) is an independent non-statutory committee established by the Australian Government Minister for Health in 1998.
    MSAC appraises new medical services proposed for public funding, and provides advice to Government on whether a new medical service should be publicly funded (and if so, its circumstances) on an assessment of its comparative safety, clinical effectiveness, cost-effectiveness, and total cost, using the best available evidence. Amendments and reviews of existing services funded on the Medicare Benefits Schedule (MBS) or other programmes (for example, blood products or screening programmes) are also considered by MSAC
  • Cancer Council Australia ( as commissioned and funded by the Department of Health ) is responsible for the development and maintenance of clinical management guidelines for the NCSP.
  • National Pathology Accreditation Advisory Council ( NPAAC ) is responsible for the development of performance measures and standards for human papillomavirus (HPV) testing and cervical cytology.
  • Quality and Safety Monitoring Committee (QSMC) - reports directly to SCoS and has been established to monitor and provide advice on the safety and quality aspects of the NCSP.

General practitioners, nurses, Aboriginal and Torres Strait Islander health workers and gynaecologists provide cervical screening testing to women, in keeping with the National Cervical Screening Policy. Information and continuing professional development for general practitioners and nurse providers is available via NPS MedicineWise, and also through the Department of Health National Cervical Screening Program website.

Colposcopists provide follow-up testing and treatment to women after a screening test prediction of cervical abnormalities. Information for colposcopists is available through the Department of Health National Cervical Screening Program website, the Colposcopy Online Learning Program, and the Cancer Council Australia NCSP website.

Pathology laboratories provide primary and reflex cervical screening testing and also diagnostic histology testing within the NCSP. For further information refer to specific sections in these webpages.

The Australian Government has established the National Cancer Screening Register (NCSR, or Register) to support delivery of the renewed NCSP and the National Bowel Cancer Screening Program.

When fully implemented, the Register will:

  • provide one record for each woman participating in the cervical and bowel screening programs; and
  • contain the clinical screening history for every woman who has ever participated in cervical screening from the migration of data from state and territory cervical screening registers. Medicare data will be used to identify women in the eligible age group (25-74 years) who have never screened.

The Register once fully implemented will replace the previous state-based cervical screening registers.

Reporting obligations for pathology laboratories

Under the National Cancer Screening Register Rules 2017 (the Rules), from 1 December 2017 pathology practitioners are required to notify prescribed cervical screening information to the Commonwealth Chief Medical Officer (CMO) through the NCSR within 14 days. Information about the notification requirement is available on the Cancer Screening website

The National Pathology Accreditation Advisory Council (NPAAC) Requirements for laboratories reporting tests for the National Cervical Screening Program require laboratories to compare their HPV positivity rates (batches of at least 2000 HPV tests) to the quarterly national average HPV positivity rate calculated from the NCSR.

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