What is the self-collection test for cervical cancer screening? How does it work and who is eligible?

Posted in cervical cancer; Posted 8 months ago by Andreas Obermair

The self-collection test for cervical cancer screening is a method where women collect their own sample for human papillomavirus (HPV) testing. HPV is a common sexually transmitted infection, and persistent infection with certain types of HPV is the cause of cervical cancer. Self-collection of a vaginal sample is safe, effective and acceptable to women eligible for screening, especially for those who find attending to doctors’ appointments challenging and as a consequence are often under-screened. Here's how it works and who is typically eligible:

How it works:

Cervical screening on a self-collected vaginal sample needs to be ordered and overseen by a healthcare provider (typically your GP) who can also ensure timely clinician-collected testing if required as part of follow-up assessment.

1. Sample Collection: The woman is provided with a self-collect information sheet and uses a swab or brush to collect a small sample of cells from the inner, top vaginal area, similar to the method used by healthcare providers during a pelvic exam. This can be done while still in the clinic or at home.
2. HPV Testing: The collected sample is then tested for the presence of high-risk HPV, which is the primary risk factor for cervical cancer.
3. Results: The results indicate whether high-risk HPV is detected in the sample. If HPV is found on a self-collected sample, you will need to go back to your GP to investigate further.

Who is eligible:

As of July 2022, self-collection of a vaginal sample for screening is available as an option for:

• anyone who is eligible for cervical screening (women and people with a cervix aged 25-74 years who have ever had any sexual contact)

• follow-up HPV testing after an intermediate risk result*

• cervical screening during pregnancy.

Who is not eligible?

In some specific cases, a co-test (test of both, a HPV test and cervix cytology on the same sample) is recommended. Self-collection of a vaginal sample for those women is not suitable because cytology cannot be self-collected (the person who tales the sample needs to visualise the cervix). If a co-test is required, a clinician-collected sample is needed; for example through your GP. A co-test may be needed in women with a past history of a high-grade abnormality, who were exposed to Diethylstilbestrol (DES) in utero, or symptoms suggestive of cervical cancer, after a total hysterectomy with a history of high-grade changes, suggestive of cervical cancer.

Is self-collection sample as accurate as using a clinician-collected sample?

Yes in women who are eligible for a self-collection sample. Earlier indications that self-collection of a vaginal sample might be less accurate were rooted in findings derived from older HPV test technology, specifically signal-based tests. However, newer evidence, based on the application of new PCR-based HPV tests, demonstrates a significant improvement. This evidence underscores that when employing a PCR-based HPV test, the efficacy of HPV testing is equivalent between clinician-collected cervical samples and self-collected vaginal samples. In Australia, laboratories are mandated to utilise PCR-based tests when examining self-collected vaginal samples.

Consult with your GP to determine the most suitable screening approach based on individual circumstances.

For more information, visit the Department of Health website 

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