GP Vivas · womens-health
Cervical screening (HPV-based program) — structured viva
Structured oral on HPV-based cervical screening: defending 5-yearly intervals with FOCAL and Cochrane data, walking the genotyped pathways, offering self-collection to a never-screened woman, the symptom rule, histology trade-offs and over-screening harms.
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RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'A colleague still does two-yearly Pap smears because five years feels unsafe — take her apart.' The viva branches through interval evidence, pathway mechanics, self-collection equity, symptoms versus screening, and treatment trade-offs.
Stem
You are the GP. A practice partner insists five-yearly screening "feels dangerous" and wants to keep doing two-yearly cytology for anxious patients. [7]
References9ShowHide
- [1]Koliopoulos G et al. Cytology versus HPV testing for cervical cancer screening in the general population. The Cochrane database of systematic reviews, 2017.PMID 28796882
- [2]Ogilvie GS et al. Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial. JAMA, 2018.PMID 29971397
- [3]Gottschlich A et al. Assessing 10-Year Safety of a Single Negative HPV Test for Cervical Cancer Screening: Evidence from FOCAL-DECADE Cohort. Journal of the National Cancer Institute, 2021.PMID 33082202
- [4]Gottschlich A et al. Human papillomavirus-based screening at extended intervals missed fewer cervical precancers than cytology in the HPV For Cervical Cancer (HPV FOCAL) trial. Gynecologic oncology, 2022.PMID 35460070
- [5]Phillips SA et al. Accuracy of HPV Self-Collection Compared with Clinician-Collected HPV Testing and Cytology: A Meta-analysis. Obstetrics and gynecology, 2025.PMID 40643571
- [6]Sultana F et al. Uptake and performance of self-collection offered through primary care to all eligible participants in a national cervical screening programme in Australia: a retrospective cohort study. The Lancet. Public health, 2026.PMID 41611360
- [7]Smith MA 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 (Clinical research ed.), 2022.PMID 35354610
- [8]Athanasiou A et al. Comparative effectiveness and risk of preterm birth of local treatments for cervical intraepithelial neoplasia and stage IA1 cervical cancer: a systematic review and network meta-analysis. The Lancet. Oncology, 2022.PMID 35835138
- [9]Verdoodt F et al. Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: a systematic review and meta-analysis of randomised trials. International journal of cancer, 2015.PMID 26296294