April 2026
Self-collection found to increase cervical screening uptake in underscreened women
By Melanie Hinze
New Australian research indicates that expanding access to self-collected cervical screening tests may improve access to underscreened women, while maintaining diagnostic accuracy.
Published in Lancet Public Health, the retrospective cohort study analysed data from the National Cancer Screening Register (NCSR), a comprehensive national data collection of human papillomavirus (HPV) tests, liquid-based cytology, histology and colposcopy results, Medicare claims and enrolment data. All HPV tests between December 2017 and December 2023 from women aged 24 years and 9 months to women aged 74 years were eligible for inclusion in the analysis.
The researchers reported that uptake of self-collected samples steadily increased after the eligibility criteria were expanded in July 2022 from 1.2% in the second quarter of 2022 to 26.9% in the fourth quarter of 2023. They also noted that since the completion of their study, ‘national data show that the uptake of self-collection in Australia has continued to rise, reaching 46% of all HPV tests in June, 2025, reinforcing the strong upward trend observed in our analysis.’
In the study, the researchers found that uptake was highest among women who were more than 10 years overdue for screening (51.9%), those living in very remote areas (53.9%) or disadvantaged areas (≤29.1%) and those aged 70 to 74 years (33.5%).
Furthermore, HPV positivity was significantly higher in self-collected samples compared with those collected by clinicians (16.4% vs 14.8%; p<0.001).
Among those referred for colposcopy, detection of high-grade lesions was similar between self-collected and clinician-collected samples, after adjusting for potential confounders. Histological detection of cancer was also similar between self-collected and clinician-collected samples.
Professor Deborah Bateson, Professor of Practice, The Cancer Elimination Collaboration and Sydney Medical School, The University of Sydney, Sydney, said that this was important research, as it was real-world data from Australia, showing that since July 2022 rates of self-collection were steadily increasing, with the biggest increases among those who were more likely to be under- or even never-screened.
‘Additionally, we have this really strong data showing the equivalent accuracy of self-collected versus clinician collected samples,’ she said. ‘It’s as accurate at detecting high-grade lesions and cancers as clinician-collected samples from the cervix with a speculum examination.’
Professor Bateson told Medicine Today that since July 2022 self-collection was now universally available in Australia, and said it should be offered as a choice for everyone who is eligible for cervical screening. She also noted that for people with the most oncogenic types of HPV (HPV 16/18) detected on a self-collected test, the guidelines recommend these people be referred straight away to [have a] colposcopy without needing to come back to the GP for a cytology test.
‘The data show that women aren’t always being referred directly to colposcopy, and we know that this can have an impact on their health outcomes,’ she added.
The National Cervical Screening Guidelines can be accessed at https://www.cancer.org.au/clinical-guidelines/cervical-cancer/cervical-cancer-screening. Cervical screening resources for patients can be found at: https://www.health.gov.au/resources/collections/cervical-screening-resources-for-health-practices-or-clinics. Easy Read information about cervical screening for people with intellectual disability is available at: https://www.health.gov.au/resources/publications/screenequal-the-cervical-screening-test-easy-read?language=en.