Cervical Screening Pathway - Routine Cervical Screening (Ages 25-69 Years)

Sep 26, 2026

Clinical pathway flowcharts for routine cervical screening and follow-up management based on HPV testing with partial genotyping and liquid-based cytology (LBC) results. The content outlines decision points for HPV detected vs not detected, unsatisfactory test outcomes, and recommended intervals for repeat testing, including referral to colposcopic assessment. It also covers management transitions across pregnancy, immune-deficient participants, post-hysterectomy screening, and investigation of abnormal vaginal bleeding, with definitions for LSIL/HSIL and possible variants.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages18

Reading Time45 min

AccessFree to download

Routine Cervical Screening (Ages 25-69 Years)

Cervical Screening Pathway (Clinician collected or self-collected)

Management of LBC prediction of HSIL in Pregnancy

Colposcopy management after LBC prediction of HSIL

Screening after hysterectomy

Investigation of people with abnormal vaginal bleeding

Table of Contents-Flowcharts 6. 1: Routine Cervical Screening (ages 25-69 years) 2 6.2: Cervical Screening Pathway (Clinician collected or self-collected) 3 6.3: Cervical Screning Pathway (Clinician collected or self-collected) 4 6.4: Cervical Screening Pathway (Clinician collected or self-collected) 5 7.1: Management of a LBC prediction of HSIL in Pregnancy 6 7.2: Management of screen detected abnormalities in immune deﬁcient screening participants 7 7.3: Screening after hysterectomy 8 8.1: Colposcopy management after LBC prediction of HSIL 9 8.2: Colposcopy management after LBC prediction of possible HSIL 10 8.3: Colposcopy management after LBC prediction of negative, pLSIL or LSIL 11 8.4: Colposcopy management after LBC prediction of atypical glandular/endocervical cells of undetermined signiﬁcance 12 8.5: Management of LBC prediction of a high grade glandular lesion (AIS) 13 8.6: Management of LBC prediction of a possible high grade glandular lesion 14 8.7: Colposcopy management when LBC result is not available 15 9.1: Test of cure following treatment for high-grade squamous abnormalities 16 9.2: Follow up after excisional treatment for AIS 17 10.1: Investigation of people with abnormal vaginal bleeding 18 􀀗􀀏􀀒􀀛 ROUTINE CERVICAL SCREENING (AGES 25-69 YEARS) HPV test with partial genotyping (ages 25-69) HPV not detected HPV detected HPV detected Unsatisfactory HPV test (not 16/18) (16/18) Routine 5-yearly LBC (reﬂex or collect cervical sample if self-collection was used) LBC (reﬂex or collect at colposcopy) Repeat as soon as practical, ideally within screening Unsatisfactory LBC Negative pLSIL/LSIL LBC pHSIL or worse* Any LBC result or unsatisfactory 6 weeks HPV detected (16/18) Routine 5-yearly screening Repeat as soon as practical, ideally within 6 weeks LBC (reﬂex or collect at colposcopy) HPV detected (not 16/18) HPV not detected Direct referral to colposcopy is recommended for screening participants who are: • aged 50+ years • Aboriginal and/or Torres Strait Islander • overdue for screening by at least 2 years at initial screen LBC (reﬂex or collect cervical sample if self-collection was used) LEGEND Test result | | Recommendation | | --- | --- | | Woman’s risk of developing cervical cancer prLJ\YZVYZ ^P[OPU [OL UL_[ Ä]L `LHYZ | | | Low | | | | Intermediate | | Higher | | Refer for colposcopic assessment HPV detected any LBC (reﬂex or collect at colposcopy) HPV not detected DES: diethylstilboestrol LSIL: low-grade squamous intraepithelial lesion HSIL: high-grade squamous intraepithelial lesion pLSIL: possible low-grade squamousintraepithelial lesion pHSIL: possible high-grade squamousintraepithelial lesion *Includes pHSIL, HSIL, cancer or glandular abnormality. Suggested citation: Cancer Council Australia Cervical Cancer Screening Working Party. Clinical pathway: Cervical screening pathway. National Cervical Screening Program: Guidelines for the management of screen detected abnormalities, screening in speciﬁc populations and investigation of abnormal vaginal bleeding. CCA 2016. Accessible from [http://wiki.cancer.org.au/australia/Guidelines:Cervical_cancer/Screening](http://wiki.cancer.org.au/australia/Guidelines:Cervical_cancer/Screening). Updated Dec 2020. 2 􀀗􀀏􀀓􀀛 CERVICAL SCREENING PATHWAY (CLINICIAN COLLECTED OR SELF-COLLECTED) HPV test with partial genotyping HPV not detected Routine 5-yearly screening | Test result | | --- | | Recommendation | | | |
Woman’s risk of developing cervical cancer | | SUHFXUVRUV ZLWKLQ WKH QH[W ðYH \HDUV | | Low | | Intermediate | | Higher | LEGEND DES: diethylstilboestrol LSIL: low-grade squamous intraepithelial lesion HSIL: high-grade squamous intraepithelial lesion pLSIL: possible low-grade squamousintraepithelial lesion pHSIL: possible high-grade squamousintraepithelial lesion *Includes pHSIL, HSIL, cancer or gl

FAQs

What are the next steps after a routine HPV test with partial genotyping when HPV is not detected?

The flowchart directs participants to return to routine 5-yearly screening using LBC, with timing based on program recommendations.

How does the pathway handle unsatisfactory HPV or LBC results?

Unsatisfactory results trigger repeat testing as soon as practical, ideally within 6 weeks, followed by the appropriate cytology and referral steps.

When is direct referral to colposcopy recommended?

Direct referral is recommended for screening participants who meet specific higher-risk criteria, including age 50+ and Aboriginal and/or Torres Strait Islander status, or being overdue by at least 2 years at initial screen.

Sep 26, 2026

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