11 December 2017

Self-testing delay mars HPV rollout

Cancer Clinical Women

Yet another delay has bedevilled the rollout of the new National Cervical Screening Program, with doctors warned not to offer women self-collection HPV tests just yet.

The Department of Health issued the notice as doctors around the country transitioned into the new screening program, officially launched this December.

While women now have access to improved HPV tests instead of cytology, the proposed introduction of self-collected testing has been delayed, likely into the next year.

Leading gynaecological pathologist, Adjunct Professor Annabelle Farnsworth, said the failure of Australia’s only reference laboratory to validate the test was behind the delay.

“It’s a brand-new test, and nobody else does it in the world,” the Douglass Hanly Moir medical director said. “So it needs to be validated in the Australian setting.”

Once Australia has an accredited laboratory, MBS funding for self-collection will become available.

A spokeswoman for the Department of Health said that doctors would be alerted by their pathology service provider when the new self-tests were available and able to be processed.

“When self-collection becomes available, eligible women may be offered this option by their healthcare provider,” she said. “Women will collect their own sample in the privacy of a healthcare setting, as per the guidelines.”

Because the collection swab was one of the elements that laboratories needed to validate to get accreditation, the spokesperson recommended GPs ask their pathology laboratory to determine which kit to offer women.

Self-collection has been introduced to encourage screening among women who have refused testing by their healthcare provider. Women over the age of 30 who have never been screened are eligible, as are those who have delayed testing by two years or more.

Professor Farnsworth reassured that women’s health would not be harmed by this delay.

“When you make such a significant change as we have made – which is enormous and the biggest change in pathology and women’s health ever – expecting everything to switch on the first of December is just not realistic,” Professor Farnsworth said.

Nevertheless, AMA President Dr Michael Gannon said the new delay was disappointing. He emphasised the importance of women undergoing the new testing according to the two-year schedule they were on under the old program, before moving to the new five-yearly testing schedule.

While self-collection was expected to improve testing rates among women who were otherwise reluctant, such as victims of sexual abuse or those who refused because of cultural reasons, Dr Gannon reiterated the superiority of testing done by healthcare practitioners over self-testing and said this should remain the recommended method of screening.