Cervical screening vs Pap smear: what changed in Australia

“Cervical screening vs the Pap smear” is a comparison a lot of people go looking for — usually because they’re due for a test and aren’t sure which one they need. The short answer: the Pap smear has been replaced, not scrapped. Australia now uses a newer, more accurate test that you can even do yourself at home. Here’s exactly what changed, and what it means for you.

Whatever happened to the Pap smear?

If you were told years ago to have a “Pap smear” every two years, you’re not imagining it — and you’re not behind. The test simply changed. In December 2017, Australia’s National Cervical Screening Program replaced the Pap smear (also called the Pap test) with the Cervical Screening Test. It’s a better test, done less often, and for most people it’s far more comfortable. The words changed too, which is why “Pap smear” can feel like it quietly disappeared — but cervical screening itself is very much still happening, and it matters as much as ever.

Cervical Screening Test vs Pap smear: what actually changed

The old Pap smear and the new test both aim to prevent cervical cancer, but they look for different things:

• The Pap smear looked for abnormal cells on the cervix — changes that had already started to happen. It was done every two years because those changes needed to be caught as they appeared.
• The Cervical Screening Test looks for HPV (human papillomavirus) — the virus that causes almost all cervical cancer. Finding HPV flags who is at risk before cell changes develop, which is why it can be done every five years and still catch problems earlier.

In other words, the new test gets ahead of the disease rather than waiting for the first signs of it. The laboratory can even run the cell check (the old Pap-style test) on the same sample if HPV is found, so nothing is lost by starting with HPV.

Can you do a Pap smear at home?

Sort of — and this is where the old name gets confusing. There is no true “at-home Pap smear”, because a Pap smear needed a clinician to take cells from the cervix with a speculum. What you can do at home is the modern version: self-collection for the Cervical Screening Test. Instead of a clinician taking the sample, you gently take your own with a simple swab — no speculum, no clinic, no one else in the room.

People search for this in all sorts of ways — an at-home Pap smear kit, a DIY Pap test, a self smear kit — but they all describe the same thing: a self-collected HPV test, which is a fully approved way to screen. Importantly, it’s not sold off the shelf at a pharmacy: because it’s a Medicare-funded screening test, a Specialist GP confirms you’re eligible and a kit is posted to your door.

Who needs screening, and how often

Cervical screening is recommended for people with a cervix who are aged 25 to 74 and have ever been sexually active — usually once every five years if your results are normal. Since July 2022, self-collection has been available to everyone eligible for routine screening, not just a limited group, so choosing to do it yourself is now a standard option rather than an exception.

One important exception: self-collection and routine screening are for people without symptoms. If you have unusual bleeding, bleeding after sex, unusual discharge or pelvic pain, that needs a clinician assessment rather than a screening test — mention it when you book so you’re pointed to the right care.

Does it hurt, and is it as good as the old test?

Two worries come up again and again, and both have reassuring answers:

• Does it hurt? Self-collection involves a soft swab you insert a few centimetres and rotate for around 20 to 30 seconds — most people find it quick and painless, and there’s no speculum involved.
• Is it as accurate as a doctor doing it? For detecting HPV, a self-collected sample is just as accurate as one a clinician takes — which is exactly why it’s an approved option under the national program. The lab runs the same HPV test either way.

If HPV is found, a Specialist GP calls you to explain what it means (a positive result is common and rarely means cancer) and to arrange the right follow-up. For most people, though, screening is a five-yearly bit of housekeeping that can now be done at the kitchen table.

Common questions

Is the Pap smear still done in Australia?

Not as the routine test. In December 2017 the Pap smear was replaced by the Cervical Screening Test, which looks for HPV rather than abnormal cells. Cervical screening still happens — it’s just a newer, better test done every five years instead of two.

What’s the difference between a Pap smear and a Cervical Screening Test?

The Pap smear looked for abnormal cells that had already started to change. The Cervical Screening Test looks for HPV, the virus that causes almost all cervical cancer, which flags risk earlier. That’s why the newer test can be done every five years and still catch problems sooner.

Can I do a Pap smear at home?

There’s no true at-home Pap smear, because that test needed a clinician and a speculum. But you can do the modern replacement at home: self-collection for the Cervical Screening Test, where you take your own sample with a simple swab. It’s often searched as an at-home Pap smear kit or DIY Pap test, and it’s a fully approved way to screen.

Does the Cervical Screening Test hurt?

Self-collection is usually quick and painless — you insert a soft swab a few centimetres and rotate it for around 20 to 30 seconds, with no speculum. If a clinician takes the sample instead, a speculum is used, which can feel uncomfortable but is brief.

How often do I need cervical screening now?

For most people with a cervix aged 25 to 74 who have ever been sexually active, every five years if results are normal — not every two years as with the old Pap smear.

Is the new test as good as the old Pap smear?

Yes — better, in fact. Because it detects HPV before cell changes develop, it can prevent more cancers while being done less often. And a self-collected sample is just as accurate as a clinician-collected one for finding HPV.