In a major step toward eliminating cervical cancer, Victoria has seen exponential growth in the uptake of HPV self-collected cervical screening tests since universal access began in July 2022. We spoke with Alvin Lee, a lead author of a new study published in BMC Medicine (and ACPCC’s Director of Population Heath), to unpack the findings.
“Self-collection has transformed the way people access cervical screening” Alvin explains. “In just two years, nearly 30% of cervical screening tests have been self-collected—that’s up from less than half a percent prior to the policy change.”
The proportion of self-collection amongst all CSTs in women who are under-screened or never-screened substantially increased by over four times across the space of 24 months. This suggests widening access has increased self-collection in under-screened and never-screened groups (even though these cohorts have had access since 2018), rather than only for women who are on-time screeners switching collection method.
The study highlights strongest uptake among older women, those in regional areas, and under-screened or never-screened populations. “These are groups that are traditionally harder to reach,” Alvin notes. “Self-collection is helping to bridge that gap.”
Despite the success, overall screening coverage dipped slightly in 2023. “It’s a reminder that accessibility alone isn’t enough—we need sustained engagement,” says Alvin. This trend highlights the complexity of factors, including transitioning from a two-yearly to five-yearly routine screening schedule, pandemic recovery, and evidence of increasing delays in accessing GP health services due to cost, particularly for women.
Importantly, the study found comparable HPV positivity rates and time to colposcopy between self- and clinician-collected tests. “That’s reassuring,” Alvin adds. “It continues to confirm self-collection is just as accurate and safe as clinician-collected tests.”
Alvin hopes the findings will guide efforts towards actively eliminating cervical cancer globally. “Offering choice in screening methods is key to equity. Self-collection is a powerful tool in that mission.”
The full scientific publication can be found here.
This work was completed in collaboration under the Victorian Cancer Screening Framework funded by the Department of Health. The framework is a partnership with the Australian Centre for the Prevention of Cervical Cancer, BreastScreen Victoria, Cancer Council Victoria, Department of Health, and the Victorian Aboriginal Community Controlled Health Organisation.
