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NHMRC guidelines

NHMRC Guidelines: Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities

In July 2006, the National Health and Medical Research Committee (NHMRC) guidelines: Screening to Prevent Cervical Cancer: Guidelines for the Management of Asymptomatic Women with Screen Detected Abnormalities were implemented in Australia. These guidelines are a population health package encompassing:

new terminology for the reporting of Pap smears (The Modified Bethesda System 2004)
information about the natural history of cervical cancer and HPV infection
the management of squamous and glandular abnormalities
management for special clinical circumstances which include:
- pregnancy
- immunosuppressed women
- women following hysterectomy
- postmenopausal women with normal endometrial cells
- women exposed to diethylstilboestrol (DES) in utero
monitoring and implementation.

The NHMRC guidelines are integral to the Australian National Cervical Screening Program.

The NHMRC Guidelines are for the management of asymptomatic women with screen detected abnormalities. Therefore women who are symptomatic need to be managed in accordance with their presenting history and symptoms. Symptoms that may require specific management outside the NHMRC guidelines include women who present with symptoms such as:

intermenstrual bleeding
post-coital bleeding
post-menopausal bleeding.

Women with any of the above signs or symptoms or any other signs or symptoms of concern should be referred for further tests to a specialist gynaecologist so that their condition can be assessed and an appropriate management plan formulated. Women with intermenstrual bleeding or post-coital bleeding should be managed in accordance with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Guidelines for the management of intermenstrual and postmenopausal bleeding. These guidelines recommend appropriate management of women presenting with intermenstrual or post-coital bleeding and referral indications.

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Last Updated: 13 December 2006
Last Reviewed: 23 September 2008