30 June 2022: Intermediate Risk Pathways and The Compass Trial Update

In 2021 the clinical management guidelines for individuals in whom HPV (not 16/18) is detected and reflex cytology is negative, were reviewed and updated.

From late 2021, the recommendation for individuals under age 50 years of age, in whom HPV (not 16/18) continues to be detected at 12 months can safely be retested in a further 12 months before being referred to colposcopy if HPV detection persists at that time¹,².

This update was made in response to the high volumes of colposcopy referrals coming from individuals and data for the first two years of the renewed National Cervical Screening Program, which showed the very low risk of invasive cervical cancers³.

The changes in the clinical management guidelines and standard care pathways in no way impact the safety of the Compass Trial. The trial was originally designed to be in line with national policy, which has since changed for intermediate risk women. We have not and cannot change the trial protocol – but the existing protocol, which sees women (participants) referred for colposcopic assessment after a second positive HPV test at 12 months, remains safe and effective.

If you are having difficulties accessing colposcopy at 12 months, please contact us to discuss available options.

1. Cancer Council Australia Cervical Cancer Screening Guidelines Working Party. National Cervical Screening Program: Guidelines for the management of screen detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding. Oncogenic HPV types not 16/18. 2017; Available from:
https://www.cancer.org.au/clinical-guidelines/cervical-cancer-screening/management-of-oncogenic-hpv-test-results/oncogenic-hpv-types-not-16-18/ title=Clinical_question:Oncogenic_HPV_types_not_16/18&_ga=2.117863113.1370173717.1652147647-1749572655.1651283063#cite_noteCitation:National_Cervical_Screening_Program_.28NCSP.29.2C_Department_of_Health.2C_Commonwealth_Government._2020-2
2. Commonwealth Department of Health. Important changes to the National Cervical Screening Program’s Clinical Guidelines pathway for women at intermediate risk. 2021 [cited 2021]; Available from: https://www.health.gov.au/news/important-changes-to-the-national-cervical-screening-programs-clinical-guidelines-pathwayfor-women-at-intermediate-risk
3. Smith M A, Sherrah M, Sultana F, Castle P E, Arbyn M, Gertig D et al. National experience in the first two years of primary human papillomavirus (HPV) cervical screening in an HPV vaccinated population in Australia: observational study BMJ 2022; 376 :e068582 doi:10.1136/bmj-2021-068582

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