Since 1991 the National Cervical Screening Program (NCSP) has offered routine screening with Pap smears every 2 years for women between the ages of 18 and 69 years. Over this time, the incidence and mortality rates for cervical cancer have both decreased by approximately 50 per cent. These rates have plateaued since 2002 and in 2011 the Australian Government commenced a ‘Renewal’ of the NCSP. The aim of the Renewal is to ensure the continuing success of the program and that all Australian women, HPV vaccinated and unvaccinated, have access to a cervical screening program that is based on current evidence and best practice.

After a rigorous and transparent process, the Medical Services Advisory Committee considered the external Evidence and the Economic Modeling reviews and made their recommendations to the Minister on 28^th April 2014. The 2 yearly Pap test for women aged 18-69 is to be replaced by:

• Five yearly cervical screening using a primary HPV test with partial HPV genotyping and reflex liquid based cytology (LBC) triage, for HPV vaccinated and unvaccinated women 25 to 69 years of age, with exit testing of women up to 74 years of age
• Self collection of an HPV sample, for an under-screened or never-screened woman, which has been facilitated by a medical or nurse practitioner (or on behalf of a medical practitioner) who also offers mainstream cervical screening
• Invitations and reminders to be sent to women 25 to 69 years of age, and exit communications to be sent to women 70 to 74 years of age, to ensure the effectiveness of the program

The new program has the potential to further reduce, by up to 30%, the incidence and mortality from cervical cancer in Australian women. The new Cervical Screening Test (oncogenic HPV test with partial genotyping and reflex LBC) will allow individual risk based assessment of a woman and appropriate management, based on her level of risk of cervical pre-cancer and cancer: low risk, intermediate risk or higher risk.

Some women and health professionals have raised concerns about the safety of the new HPV test, the increased screening interval and the later age of starting screening. Educational materials, emphasising the safety of the new program, have been developed, and their dissemination is integral to successful implementation.  The new NCSP 2016 Guidelines recommend new approaches to screening women from specific populations, such as the DES exposed, those exposed to early sexual activity <14years of age, the immune-deficient and Aboriginal and Torres Strait Islander women.