Cervical cancer and cervical screening
How the National Cervical Screening Program replaced the Pap smear with 5-yearly HPV testing and self-collection, what each result means, the symptoms that need referral whatever the screening history, FIGO 2018 staging, and surgery, chemoradiation and immunotherapy under the 2026 ESMO guideline.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Almost all cervical cancer is caused by persistent high-risk HPV, mainly types 16 and 18. About 70% are squamous cell carcinoma and 25% adenocarcinoma.
- Australia replaced the 2-yearly Pap smear with the 5-yearly HPV test in December 2017, and opened self-collection to everyone eligible in July 2022.
- Most cancers now occur in people who were never or under-screened. Aboriginal and Torres Strait Islander women have about twice the incidence and three to four times the mortality.
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Sources
- National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleedingAU/NZCancer Council Australia
- Important changes to the NCSP clinical guidelines pathway for women at intermediate risk (effective 1 February 2021)AU/NZNational Cancer Screening Register, 2021
- National Strategy for the Elimination of Cervical Cancer in AustraliaAU/NZAustralian Government Department of Health and Aged Care, 2023
- Optimal care pathway for people with cervical cancerAU/NZCancer Council Australia
- eviQ Cancer Treatments Online (gynaecological protocols)AU/NZCancer Institute NSW
- Lorusso D et al. Cervical cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2026;11:108364European Society for Medical Oncology, 2026
- Cibula D et al. ESGO/ESTRO/ESP guidelines for the management of patients with cervical cancer: update 2023. Radiother Oncol 2023;184:109682European Society of Gynaecological Oncology, 2023
- NCCN Clinical Practice Guidelines in Oncology, Cervical CancerNational Comprehensive Cancer Network
- Ramirez PT et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer (LACC). N Engl J Med 2018;379:1895-904New England Journal of Medicine, 2018
- Lorusso D et al. Pembrolizumab or placebo with chemoradiotherapy for high-risk locally advanced cervical cancer (KEYNOTE-A18). Lancet 2024;403:1341-50 (progression-free survival); overall survival in Lancet 2024;404:1321-32The Lancet, 2024
- McCormack M et al. Induction chemotherapy followed by standard chemoradiotherapy versus chemoradiotherapy alone in locally advanced cervical cancer (INTERLACE). Lancet 2024;404:1525-35The Lancet, 2024
- Colombo N et al. Pembrolizumab for persistent, recurrent, or metastatic cervical cancer (KEYNOTE-826). N Engl J Med 2021;385:1856-67New England Journal of Medicine, 2021
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback