Cervical cancer is one of the most preventable cancers, and New Zealand’s screening programme is designed to catch early changes long before they become dangerous. With the shift to primary HPV testing in 2023, many people are unsure whether they still need a smear, when screening starts, and when it stops. Here’s a clear guide to help you understand what’s recommended — and why.
When Cervical Screening Starts in New Zealand
Screening begins at age 25 for anyone with a cervix. This applies regardless of sexual history, gender identity, or HPV vaccination status.
Screening before age 25 is not recommended, even if someone became sexually active earlier. Evidence shows the harms outweigh the benefits in this age group because HPV infections are common and usually clear on their own.
When Cervical Screening Ends
Routine screening ends at age 69, but people aged 65–74 may need an “exit test” depending on their previous results. You can stop screening if you have:
Two consecutive negative cytology tests after age 62 (one after age 65), or
An HPV “not detected” result after age 65 (age 67 if immune‑deficient).
If these criteria aren’t met, an HPV test is recommended before exiting the programme.
Reasons You Do Need a Smear (Cytology)
With the new HPV‑first system, most people will not need a smear unless HPV is detected. But cytology still plays an important role.
You need a smear when:
Your HPV test is positive — cytology helps determine whether abnormal cells are present as a result of the presence of HPV.
You have symptoms such as post‑coital bleeding, abnormal discharge, or unexplained pelvic pain (this is diagnostic, not screening).
You’ve had previous abnormal results and are in a follow‑up pathway.
You’ve had treatment for cervical abnormalities and require surveillance.
Your clinician cannot obtain a valid HPV sample (rare).
Reasons You Do Not Need a Smear
You do not need a smear when:
Your HPV test is “not detected.” This is now the primary screening result. No smear is required.
You are under 25. Screening is not recommended.
You’ve had a total hysterectomy (uterus and cervix removed) unless your clinician advises otherwise for specific medical reasons.
You are 69+ and meet exit criteria.
You are pregnant and have a normal HPV result. (Screening is safe in pregnancy, but not required if you’re up to date.)
You have no symptoms and are up to date with screening.
Why HPV Testing Comes First
HPV causes almost all cervical cancers, and detecting the virus early is more effective than relying on cytology alone. HPV testing is:
Sensitive at picking up risk early
Less frequently tested (every 5 years for most people)
Available as self‑testing, which increases accessibility and comfort
Cytology (the smear) is now a secondary test, used primarily when HPV is present or when symptoms require further investigation.
What This Means for You
Most people will now have a quick HPV test every 5 years, often self‑collected. A smear is needed if HPV is detected or if symptoms arise.
This shift reduces unnecessary procedures, improves early detection, and makes screening more accessible — especially for those who previously avoided smears due to discomfort or trauma.
If You’re Due for Screening
You can be screened at:
Your GP or nurse
Māori, Pacific, or women’s health clinics
Family Planning
Sexual health services
Outreach or mobile units
Some providers offer take‑home self‑test kits