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CHANGE OF TIMING TO UPCOMING IMPROVEMENTS TO THE CERVICAL SCREENING PROGRAMME KEY MESSAGES FOR STAKEHOLDERS Change of timing for improvements to the National Cervical Screening Programme The Ministry of Health has announced changes in timing for upcoming improvements to the National Cervical Screening Programme (NCSP). “The Ministry has reviewed the implementation timeframe, and decided on a phased approach,” says Clinical Director of the National Screening Unit, Dr Jane O’Hallahan. “We’re extending the transition to full Human Papillomavirus (HPV) primary screening, to allow time to develop a more robust IT system to underpin the NCSP. However, we’re still able to push on with implementing the change to increase the start age for cervical screening from 20 to 25 years. Screening in this age group provides little benefit to women, and can cause harm.” Since the inception of the NCSP in 1990, there has been no reduction in cervical cancer incidence and mortality rates for women under 25 years of age. The decision to stagger the timeline means the plan to raise the screening start age to 25 years will still take place in 2019, reducing the potential harm of overtreatment for women in this age group. A date for a full transition to HPV primary screening is still to be decided, however we are working towards commencing this from 2021. “For HPV primary screening to be safely introduced, the clinical pathways must be supported by a fit for purpose IT solution. Simply adapting the current IT system is not a viable option,” Dr O’Hallahan says. “It makes sense to take the time to develop a common shared IT solution (National Screening SolutionNSS) that enables the nationwide delivery of all our screening programmes. This will be starting with the National Bowel Screening Programme and extending over time to be the IT solution that enables the nationwide delivery of screening programmes. This will lead to an improved consumer experience for participants of all New Zealand screening programmes” says Dr O’Hallahan. In the short term, a key focus of the Programme will continue to be improving equitable access to screening for priority women (Māori, Pacific and Asian, and any women who are unscreened or under screened). “Continuing to have regular screening every three years offers women the best protection by detecting changes that could indicate an increased risk of developing cervical cancer,” says Dr O’Hallahan. “New Zealand has one of the most successful cervical screening programmes in the world, so we need to make sure improvements to the Programme are carefully rolled out to protect the integrity of the Programme.”


BACKGROUND The transition to HPV primary screening involves changing the primary cervical screening test from analysing cells by cytology (detects changes that indicate an abnormality associated with an increased risk of developing cervical cancer), to using a test to screen for HPV – the virus that causes more than 90 per cent of cervical cancers. Background on HPV primary screening Testing for HPV is internationally recognised as a better primary test for cervical screening. A number of countries are implementing HPV primary screening including Australia, the UK and the Netherlands. The International Agency for Research on Cancer and the World Health Organisation have also endorsed HPV testing as the primary screening method for cervical cancer. What happens at a women’s cervical smear appointment will not change in terms of the examination they receive. An HPV primary screening test means that women will only need to be tested every five years (as opposed to every three years within the current cytology based screening programme) as a negative HPV test gives greater assurance that they are very unlikely to develop abnormal cervical cell changes. Background on the decision to raise the screening age to 25 years of age There is now a strong body of evidence that screening women between the ages of 20 and 24 years provides little benefit to women and can cause harm. Harms of screening women in this age group includes the potential for over-diagnosis, increased stress and anxiety associated with additional tests and treatments, and unnecessary colposcopy. The age change is in line with that of many other countries including Australia, England, Scotland, the Netherlands, France, Belgium, Ireland, Italy, and Norway. The World Health Organisation’s International Agency for Research on Cancer recommends that cervical screening begins at age 25. The HPV vaccination programme available through schools and primary care services offers the best protection to younger age groups from HPV infections. There will be accelerated progress with the programme’s coverage rates with boys now being offered the vaccination since 2017. Any woman, including someone outside the age group for screening, who notices any symptoms, such as unusual bleeding, discharge or pain, should seek prompt medical attention regardless of their screening history or eligibility.

NCSP Update  
NCSP Update