HPV screening: why patient education is key

Uptake is high, with around 80 per cent of clients choosing the HPV self-test when offered and screening rates improving. But it’s vital that health practitioners can provide full screening services and educate their clients when traditional smear tests are more appropriate. 

Sexual Wellbeing Aotearoa has been training health practitioners on cervical screening since the late 1980s and providing cervical screening to clients since 1957. As the largest single cervical screening organisation in the country, we welcomed the move to HPV primary screening in September 2023 as an exciting step towards improving access to service and reducing inequity.

But HPV vaginal swabs are not a direct replacement for traditional smear tests (liquid-based cytology, LBC). Healthcare providers must have enough staff trained to provide LBC screening where needed, as well as clinicians with the knowledge to educate patients about the most appropriate screening option for them.

The HPV vaginal swab is a new type of screening test for high-risk types of human papillomavirus (HPV) which can cause cancer if left untreated. It has been the primary method of cervical screening in Aotearoa since September 2023. The swab can be taken by the client themselves or completed by a health professional.

Pros of HPV vaginal swab:

• clients can complete it themselves
• health professionals don’t need to be certified cervical screeners to provide HPV vaginal swabs 

Cons of HPV vaginal swab:

• not appropriate for people who have symptoms
• clients who results come back as “HPV other” will need to rebook for another test (normally an LBC screening) 

Also known as a “smear test” or “pap smear”, liquid-based cytology (LBC) was the only cervical screening method in Aotearoa until September 2023. A speculum is inserted into the vagina and a sample is taken from the cervix. This test needs to be performed by a certified health professional.

Pros of LBC screening:

• there's no need to rebook for a second screening test if the results come back as “HPV other”
• also tests for HPV 

Cons of LBC screening:

• some people find the procedure uncomfortable
• only certified cervical screeners can perform this test, which means it can take longer to get an appointment, or may not be with their preferred clinician 

Clients are increasingly interested in HPV and aware of the importance of cervical screening and HPV vaccination. We’ve noticed this both in our own clinics, and in our cervical screening courses, as one participant explains:

“I've noticed more engagement and interest from clients in understanding HPV and the reasons why we conduct screening. It's more empowering for women.”

But clients don’t always understand that depending on their history, an HPV vaginal swab not be appropriate. It’s our job as clinicians to educate clients about their screening options, identify when follow-up is needed, and empower them to make their own choices. Our cervical screening courses aim to give health professionals the knowledge needed to do this, as well as to carry out LBC screening. 

Our cervical screening courses aim to give health professionals the knowledge they need to discuss screening options with clients in light of their screening and medical history, carry out LBC and HPV screening, and to analyse test results. Participants value this comprehensive approach.

“Being able to educate patients on HPV has been great for both myself, and for my patients. I've had many patients say ‘Wow, I never knew that!’” – course participant 

“Having the knowledge to back up their questions creates a sense of confidence in my practice which also gives reassurance to my patients that they have the best understanding of their care.” – course participant

We have cervical screening courses coming up around the motu.

You can get cervical screening from us, or you can go to your usual screening provider.

Learn more at Time to screen or check out Smear Your Mea on Facebook