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

Posted in cervical cancer; Posted 9 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 

If you wish to receive regular information, resources, reassurance and inspiration for up-to-date care that is safe and sound and in line with the latest research, please subscribe to my blog via the form above, or like Dr Andreas Obermair on Facebook.