Cervical screening self-collection puts the swab in your hands, behind a curtain

There is no speculum, and you take the sample yourself. The sample can be taken in a private space, the federal health department says, “behind a curtain or in the bathroom”. This is cervical screening self-collection. Since 1 July 2022, everyone eligible for screening in Australia has been able to choose it over a sample taken from the cervix by a healthcare provider using a speculum.

In 2021, 4,663 screening tests in Australia were self-collected. In 2024 there were 535,817, more than a hundred times as many. Both counts come from the Australian Institute of Health and Welfare (AIHW) and cover people aged 25 to 74. Until July 2022, the institute says, self-collection was limited to people who were two or more years overdue for screening or had never been screened. The number rose rapidly once those restrictions were lifted and all participants became eligible.

A red mark near the tip

Self-collection still goes through a healthcare provider, who supplies the swab and instructions for using it. Cancer Council SA spells out the steps. The red cap is twisted and the swab pulled out. The aim is to insert it into the vagina as far as the red mark closest to the tip. It is then rotated gently one to three times, put back in its tube and returned to the doctor, nurse or Aboriginal Health Worker. The person is told to contact the clinic for results in two weeks.

Cancer Institute NSW says a screening test on a self-collected vaginal sample is as accurate as one on a sample a clinician takes from the cervix during a speculum examination, and cites a 2018 meta-analysis. The department calls both methods accurate and safe, and says self-collection can also be used for a follow-up HPV test after an intermediate risk result, and for screening during pregnancy.

Every five years, from 25 to 74

The test looks for HPV, the human papillomavirus. Cancer Council SA says it is recommended every five years for women and people with a cervix aged 25 to 74 who have ever been sexually active. Having had the HPV vaccine does not take anyone out of that group.

The department says there is “a Medicare rebate for the Cervical Screening Test” and that if the healthcare provider bulk bills, “there should be no cost to you”, though some providers charge a consultation fee above the rebate. Most pathology providers bulk bill the testing itself, but sometimes one may send an invoice. People without a Medicare card can still be screened; for them, it adds, the test “will incur a cost”.

What cervical screening self-collection cannot show

A self-collected sample can be tested for HPV and nothing else. It cannot be used for cytology, the check for abnormal cervical cells, Cancer Institute NSW says. If HPV is found, the type decides the next step: a speculum examination so the cells can be checked, or referral straight to colposcopy. The institute also says self-collection is not suitable for anyone who needs a co-test, for example because of symptoms such as unusual vaginal bleeding, pain or discharge.

The AIHW tracks whether that next step happens. In 2024, 26,163 people aged 25 to 74 who self-collected tested positive for a cancer-causing type of HPV other than 16 and 18. For them, the AIHW notes, the recommendation is a practitioner-collected sample within six weeks; 76.3 per cent had the follow-up cytology test within three months. Another 9,371 tested positive for HPV 16 or 18, a result that marks a person as higher risk, with colposcopy recommended within eight weeks. Of those, 61.0 per cent had one within three months.

Modesty, in the department’s words

People from culturally and linguistically diverse backgrounds are less likely than the general population to have cervical screening tests, the department tells clinicians in its guidance. Among the barriers it lists are “fear, modesty and embarrassment around the test” and a lack of knowledge about the screening choices open to them. The availability of female healthcare providers and female interpreters is on the list too. Cancer Institute NSW tells clinicians to consider an interpreter where needed, and says the service is free.

That is a wide grouping, spanning many languages and countries of birth. The AIHW’s 2025 monitoring report does not break participation down by country of birth or language spoken at home. It gives no rate for women born in India.

Cancer Institute NSW counts these communities among the groups less likely to screen, a list that also includes Aboriginal and/or Torres Strait Islander peoples, people with disabilities, people who have experienced sexual violence and people with previous negative screening experiences. Self-collection may be more acceptable to these groups, it says, and it cites a pilot run in Victoria from November 2015 to December 2016. The women in it had not been screened in more than three years, or at all, and had declined a Pap test. Of the 98 offered self-collection in a clinic, the pilot’s evaluation report shows, 79 agreed to it and five agreed to a Pap test after all. That took screening participation to 85.7 per cent.

Fewer than four in 100,000

The department’s summary of the National Strategy for the Elimination of Cervical Cancer in Australia puts the elimination target at fewer than four cases for every 100,000 women, and says carrying out the strategy will lead to elimination by 2035. For 2021, the AIHW reports an age-standardised rate of 6.2 new cases per 100,000 women of all ages. That year 886 women aged 25 to 74 were diagnosed with cervical cancer, and in 2023, 210 women in the same age group died of it. Since the national screening program began in 1991, the AIHW says, incidence and mortality have halved.

In 2024, more than half a million screening tests in Australia began with a swab and no speculum.