Ask a group of Australian women which “smear test” they should book and many will still call it a Pap test, even though the screening path changed years ago. Under the Australian Government Department of Health, Disability and Ageing, which runs the National Cervical Screening Program, anyone with a cervix aged 25 to 74 is recommended to have the Cervical Screening Test every 5 years. The current test looks for HPV, the virus the department says “targets HPV, which causes almost all cervical cancers”.
Recommended age range: 25–74 years · Recommended interval: Every 5 years · Current test: Cervical Screening Test · Cost with Medicare: Free when bulk-billed · Cost without Medicare: About $50–$150
Confirmed facts
Sometimes the numbers are the quickest way to reset what you think you know about cervical screening.
| Recommended age range | 25–74 years |
| Recommended interval | Every 5 years |
| Primary test | Cervical Screening Test — detects HPV |
| HPV link to cervical cancer | Causes almost all cervical cancers |
| Cost with Medicare | Free when bulk-billed |
| Cost without Medicare | Usually $50–$150 |
| Who needs screening | People with a cervix aged 25–74 who have ever had sexual contact |
Pap smear vs Cervical Screening Test: what changed
Most people still say “Pap smear”, but Australia’s national program now uses the Cervical Screening Test. According to the Australian Government Department of Health, Disability and Ageing, the current test is built around HPV testing and is “more sensitive and specific than the Pap test”.
Role of HPV testing
An older Pap test was designed to find abnormal cervical cell changes. The current test, by contrast, looks first for the virus that causes those changes. If HPV is not found, the result is reassuring and the recommended interval is 5 years. If HPV is found, follow-up can include reflex cytology — a second look at the cells from the same screening sample.
The easiest way to see why “it’s just a Pap smear” is wrong is to put the old language and the current test side by side.
| Point of comparison | Pap test — the phrase people often use | Cervical Screening Test — current national screen |
|---|---|---|
| Main target | Abnormal cervical cells | HPV, the virus linked to almost all cervical cancers |
| Recommended interval | Often linked to older cytology-based screening | Every 5 years after a negative HPV result |
| Medicare item | Not the current routine pathway | Item 73070 or 73071, free when bulk-billed |
Why this matters: The Department of Health says cervical cancer is rare in people under 21 and false positives are common in that age group. That is part of why routine screening does not start at 21, and why the current test is not the old annual Pap.
The implication: the shift from Pap to HPV testing is not a cosmetic rebrand — it allows a safer five‑year interval and a more reliable result.
Who should be screened and when
The Australian Government Department of Health, Disability and Ageing recommends the Cervical Screening Test every 5 years for anyone with a cervix aged 25 to 74 who has ever had sexual contact.
Recommended age range for cervical screening
Screening in Australia starts at 25 and continues until 74. The department’s advice is straightforward: anyone aged 25 to 74 who has a cervix and has ever had any type of sexual contact should be screened.
Screening interval: every 5 years
The 5-year interval is not because the test is less sensitive. It is because the HPV test is more sensitive than the old Pap approach, and a negative HPV result means the risk of developing significant cell changes is low. The department also notes that updated guidelines support the safety of extending the interval after a negative HPV screen.
Why screening doesn’t start at 21
People often ask why there is “no Pap smear before 21”. The Department of Health says cervical cancer is extremely rare in that age group and false positives are common. Around 2% of cervical cancer cases are in people aged 20 to 24, which is one reason the program screens older people rather than teenagers.
What if you’ve never had sex?
The Australian Government Department of Health, Disability and Ageing is clear that cervical screening is recommended regardless of sexual history. HPV can be transmitted through skin-to-skin contact, not only intercourse, and the test is aimed at preventing cervical cancer in people who may have been exposed to the virus.
What this means: Most people aged 25–74 with a cervix need screening every five years, not yearly. The five‑year interval is safe because the HPV test is highly sensitive.
What the test does and doesn’t tell you
The current test is designed as a routine screen for people without symptoms. That is more important than it sounds. According to the Medicare Benefits Schedule, which sets the rules for Medicare items 73070 and 73071, the routine test must be for an asymptomatic patient as part of routine 5-yearly screening.
Is a Pap smear painful?
Most people experience only mild discomfort during the test, which typically lasts a few seconds. The speculum insertion can cause pressure or a brief pinching sensation.
That means a common “what not to do after a Pap smear” answer is really a screening answer: don’t use the routine test as a diagnostic test. If you have unusual bleeding, pain, discharge, or other symptoms, tell your doctor before you book a routine screen. The next five-yearly screen is not the right way to work up a symptom.
Medicare and out-of-pocket costs
Under Services Australia, the agency that manages Medicare rebates, the Cervical Screening Test is covered every 5 years for eligible people. If your GP or nurse bulk-bills the visit, the test itself can be free.
Services Australia also notes that without Medicare, the test usually costs between $50 and $150. That is why it is worth asking when you book whether the practice bulk-bills cervical screening appointments.
What to watch: If you are due for screening, do not assume the old “Pap test” is what will happen. Ask for the Cervical Screening Test, and confirm with your provider that you are eligible for the Medicare-rebated, 5-yearly test.
The catch: the routine Medicare item is only for asymptomatic patients, so screening cannot substitute for diagnostic work‑up when you have symptoms.
What the experts keep saying
“Anyone with a cervix aged 25 to 74 who has ever had any type of sexual contact should have a Cervical Screening Test every 5 years.”
— Australian Government Department of Health, Disability and Ageing
“Medicare covers the cost of a Cervical Screening Test every 5 years if you are eligible, and the test is free when the provider bulk-bills.”
— Services Australia
“Items 73070 and 73071 are for asymptomatic patients as part of routine five-yearly screening.”
— Medicare Benefits Schedule
How to get the test
- Check your age and interval. If you are aged 25 to 74 and are due, you are eligible to book.
- Book with a GP or nurse. You can ask the receptionist whether the clinic provides cervical screening.
- Say it’s a Cervical Screening Test, not a Pap test. This helps make sure you get the current Medicare-rebated test.
- Ask about bulk-billing when booking. The test can be free when the practice bulk-bills the visit.
- Do not wait if you have symptoms. Tell the practice if you have unusual bleeding, pain, discharge, or other changes. Routine screening is not a diagnostic test.
The takeaway
The move from Pap smear to HPV-based Cervical Screening Test is not a cosmetic rebrand. It is why Australia can recommend a safe five-year interval instead of an annual test, and why a negative HPV result is such a useful result. Missing that message is the real gap between what patients call the test and what the test is actually doing.
www9.health.gov.au, cancer.nsw.gov.au, snp.com.au, shvic.org.au, health.gov.au, www1.racgp.org.au, health.gov.au
Frequently asked questions
Is the Cervical Screening Test the same as a Pap smear?
No. The current national test is the Cervical Screening Test, which looks for HPV first. The Australian Government Department of Health, Disability and Ageing says the HPV test is more sensitive and specific than the older Pap test.
Do I need cervical screening if I have never had sex?
The Department of Health says screening is recommended regardless of sexual history. HPV can be transmitted through skin-to-skin contact, not only intercourse.
Why is the interval every 5 years instead of every 2?
A negative HPV result means the risk of significant cell changes is low. That is why the national program recommends a five-year interval for most people aged 25 to 74.
How much does a cervical screening test cost?
Services Australia says the test is covered every 5 years for eligible people and is free when the provider bulk-bills. Without Medicare, the test usually costs between $50 and $150.
What should I do if I have symptoms before my next screen?
Do not wait for your next routine screen. The routine Medicare item is for asymptomatic people. If you have unusual symptoms, see a doctor before the next five-yearly screen is due.
Related reading
- Cancer Council Australia – cervical screening
- Department of Health – Swish with your sistas campaign
- National Cervical Screening Program overview
Alex Chen is Editor-in-Chief at Reef Brief, overseeing editorial standards, publication decisions and corrections.