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The National Cervical Screening Programme (NCSP) uses HPV primary screening in Aotearoa New Zealand. International research shows that HPV primary screening provides 60 – 70% more protection against invasive cervical cancer when compared with cytology screening.
The World Health Organisation’s (WHO) strategy is to eliminate cervical cancer. This means for every 100,000 people with a cervix, less than four should experience cervical cancer. The NCSP has made significant progress towards this goal, but there is still more to be done.
It has been found that 85% of people who develop cervical cancer in Aotearoa New Zealand have never been screened or may have been screened infrequently. Additionally, Māori and Pacific peoples tend to experience higher rates of cervical cancer, so addressing inequities in screening is important.
Health New Zealand's role
Health New Zealand | Te Whatu Ora runs the National Cervical Screening Programme, including regional coordination of services, health promotion, and engagement with key organisations and individuals relevant to cervical screening.
Health NZ also contracts the service providers that provide screening support services for those who need additional support to be screened or to attend colposcopy appointments.
The effectiveness of cervical screening in Aotearoa New Zealand
The incidence of cervical cancer in Aotearoa New Zealand has decreased by about 50% since the NCSP began in 1990. The incidence of cervical cancer as of 2017 was 6.1 per 100,000 people with a cervix. The goal of HPV Primary Screening is to reduce this number to below 4 per 100,000.
Death caused by cervical cancer has reduced over 60% since the NCSP was introduced and cervical cancer mortality in 2016 was 1.7 per 100,000 people with a cervix.
Screening for HPV and test options
HPV primary screening looks for the presence of human papillomavirus (HPV). For most people an HPV infection clears by itself within two years (especially in people under 30). Sometimes HPV can cause a persistent infection, so screening helps us know if additional diagnostic testing or treatment is required.
Participants should be made aware that they have two cervical screening test options:
- A HPV vaginal swab test, either by self-test or assisted by a clinician
- A liquid based cytology sample, which is tested for HPV
If HPV is detected cytology will be processed automatically without the person needing to return for another test.
Recommended screening frequency
Those who receive an HPV Not Detected test result during HPV Primary Screening are at very low risk of developing high-grade cell changes within five years, so the screening interval is five years.
Participants will not move to a five-year screening interval until they return an HPV Not Detected result.
Those who are immune deficient are at higher risk of developing cervical cell changes, and should be screened every three years. This includes:
- Those living with HIV
- Pharmaceutically immunosuppressed individuals
- Individuals who are otherwise immunocompromised
See our FAQ page for more clinical information about HPV primary screening.