Australian doctors are reporting a dramatic increase in colposcopy referrals, the numbers of which are swamping the public health system. Many of these women are now being forced to either face long waiting periods for the public health system or opt to go private to be seen sooner.

Colposcopy is a diagnostic procedure that women are referred for following a positive cervical screening test result. It looks closely at the cervix, as well as the vulva and the vagina. It involves the insertion of a speculum into the vagina and the use of a magnifying instrument called a colposcope which allows for close examination to identify abnormalities on the cervix and surrounding tissues. A biopsy may be performed at the same time if necessary.

Receiving a positive cervical screening test result is incredibly stressful, and this stress is being compounded for women who, in some areas, are being required to wait for as long as four to six months to undergo a colposcopy within the public health system.

Pathology provider Douglass Hanly Moir, via the Medical Journal of Australia, reported that upon analysis of 200,000 HPV cervical screening tests performed in the first six months of the screening program, 5,200 women were referred on for colposcopy. This figure is three times higher than that resulting from the Pap Smear test and is due to the fact that the HPV test is far more sensitive.

With these higher referral rates, women who returned a positive HPV result yet were considered by their doctor to be non-urgent, were redirected to larger public gynaecology clinics and faced either long waits on cancellation lists or being forced to go private to be seen sooner.

So why has the rate of positive cervical screening results risen so much, leading to so many more colposcopy referrals?

The New Cervical Screening Test – Explained

Women have long been advised to undergo cervical screening on a regular basis, as early detection is the key to identifying and curing cervical cancer.

The Pap Test previously sought to identify cells on the cervix that were abnormal. Women were advised to undergo this test from the age of eighteen, every two years providing all results were clear in the interim.

In Australia, the traditional Pap Smear test was replaced by the Cervical Screening Test on December 1, 2017. The experience of undergoing this test is no different for women than having a Pap test was, however, the science behind it differs somewhat.

The new Cervical Screening Test instead detects the presence of the Human Papilloma Virus, or HPV, on the cervix. HPV is the cause of the vast majority of cervical cancers.


What Does a Positive HPV Result Mean?

The HPV infection is very common in both men and women, and it is directly linked to an array of conditions including genital warts, cervical cancer, anal cancer, and many cases of cancers of the vagina, vulva, penis, and the back of the throat. Four in five people unknowingly experience at least one form of HPV at some point in their lifetime, and most cases are cleared by the immune system with no lasting impact. School-age adolescents are now vaccinated against nine forms of HPV.

If HPV is identified on your cervical cells, the same cells will be analysed to determine whether or not they have changed or display any abnormalities. Your doctor will be informed which type of HPV is present and whether the cells have changed.

Abnormal cell results or the presence of HPV do not mean you have cancer – not all types of HPV cause cancer and not all test abnormalities are caused by cancer (infection and inflammation can be the cause of some). Many suspicious changes that are identified are at a very early stage and treatment is quite simple.

A positive Cervical Screening test result simply means that you need further assessment, and the first step is a colposcopy.


The Importance of Screening

According to the Australian Institute of Health and Welfare,

  • Cancer of the cervix is the 14th most commonly diagnosed cancer among Australian women
  • 951 women will be diagnosed with cervical cancer in 2019
  • An Australian woman’s risk of being diagnosed with cervical cancer by her 85th birthday is 1 in 494.


Cancer of the cervix is amongst the most preventable of all cancers and one of the most curable.

Early detection and treatment is the key to surviving and overcoming cervical cancer for a normal life. The majority of women who die from cervical cancer have not adhered to their recommended screening intervals. Smoking is another risk factor for cervical cancer which women can address to mitigate their risk.


Gynaecology Centres Australia

Australian women should commence cervical screening at age 25 and continue until age 74 unless the cervix is completely removed as part of a hysterectomy or similar gynaecological surgery. A woman who has a clear screening result identifying no HPV infection needs to be tested only at five-year intervals.

Gynaecology Centres Australia (GCA) provides an array of women’s health services including cervical screening. For more information on our women’s health services, including contraception and termination of pregnancy services, contact us today via our “Contact Us” page on our website.