Screening tests are used to find cancer before you have any symptoms and improve the likelihood of successful treatment.
There are three national screening programmes for breast, cervical and bowel cancer.
We recommend people take part in these programmes provided they understand the benefits and potential risks.
- Breast screening - 45 to 69 years old
- Cervical screening - people with a cervix from 25 to 69 years
- Bowel screening - 60 to 74 years old
If you have any signs, symptoms or concerns, you should visit your doctor as soon as possible - not wait for your next screening test.
Other screening tests:
- Prostate screening - not offered as a national programme.
- Lung screening - Waitematā and Auckland District Health Boards are conducting a trial of lung cancer screening for Māori (using low-dose computerised tomography (LDCT)).
A few people are at higher risk for breast, bowel or cervical cancer because of family history or other factors. Talk to your doctor about your risk. You may need to have tests more often and from a younger age.
Breast screening can save lives by finding breast cancer early when it is easier to treat.
If you are aged 45 to 69, have your free breast screen (mammogram) every two years.
A mammogram is an xray of your breasts. It can be used to find early signs of breast cancer before it is big enough to feel or cause symptoms.
Your appointment will be at a clinic or a mobile breast screening bus.
You will stand at an xray machine. Each breast will be placed on a machine and firmly pressed between two plates for a short period. You will feel some pressure that can be uncomfortable.
Two xrays are taken of each breast at different angles.
It takes around three weeks to get the results. If nothing is found you will get a letter.
If something needs further investigation or the mammogram was unclear. you will get a phone call. This may include another mammogram, an ultrasound or a biopsy.
Women of any age should be breast-aware, even if you are having mammograms.
Mammograms are not perfect tests. Some cancers may be missed, which may delay getting treatment.
Sometimes mammograms find things that look like cancer but are not. This leads to more testing and can cause unnecessary worry and anxiety.
Overdiagnosis, where a low-risk type of breast cancer is found that never would have caused any health problems if left alone is also a risk. Because it’s not possible to tell the harmful cancers from the harmless ones everyone is usually offered treatment. This may include surgery and radiotherapy which can have serious side-effects.
You will be enrolled automatically when you turn 45.
Having routine cervical screening tests is one of the most important things you can do to prevent or find cervical cancer early.
People who are aged 25 to 69 years of age and have a cervix (including trans or non-binary people) and have ever been sexually active should have a test.
HPV virus is the main cause of cervical cancer
Almost all cases of cervical cancer are caused by the human papillomavirus (HPV).
This virus is very common and spread through close intimate/sexual contact.
Most infections will clear up by themselves within a few months. A small number of women are infected with high-risk HPV and if this is not treated, can grow over several years into cervical cancer.
Screening finds HPV infection or precancerous cell changes caused by the virus that can be treated and cancer avoided.
A vaccine for HPV is available. The HPV vaccine is free for people aged between 9-26 years under the National Immunisation Schedule.
The HPV vaccine is very effective at protecting against the types of Human papillomaviruses (HPV) that most often cause cervical cancer. The vaccine also protects against HPV types that cause other genital, anal, throat and mouth cancers in both males and females.
HPV is spread by sexual contact.
The HPV Gardasil® 9 vaccine is free for males and females aged between 9-26 years under the National Immunisation Schedule.
It is offered in two doses to primary school aged children in year 8. It works best before any exposure to HPV (before any sexual contact).
If you missed out on getting the vaccine at primary school, you can get a vaccine at your health centre. It will prevent new HPV infections.
Its still very important to continue having cervical screening tests as the vaccine protects against most but not all HPV types that cause cervical cancer.
Find out more:
- Ministry of Health information on the HPV immunisation programme
- The Immunisation Advisory Centre, University of Auckland
- HPV New Zealand information about the virus, including symptoms
The cervical screening test
The test checks the health of your cervix (the entrance to your uterus/womb) by looking for changes to the cells. It involves taking a small sample of cells from your cervix with a small, soft brush.
These cells are put into a special liquid and checked at a lab. Most people will receive a normal result (everything is fine). If everything is normal you will get a reminder in three years.
You can have your test done by a doctor, nurse or trained smear-taker at:
- your usual local health centre
- community health service e.g. Pacific or Māori health centre
- sexual health service
- women’s health service
You should have a smear test if you:
- have a cervix
- Are 25 to 69 years old and have ever been sexually active (with males or females)
- whether or not you have been vaccinated for HPV
- you may still need a test if you have had a hysterectomy - check with your doctor
- Cervical screens are usually every three years. After your first test, and if there have been more than 5 years between tests it will be repeated in 12 months
How much will a smear cost?
This depends on where you get your test. At your local health centre, you will be required to pay your usual GP fee or a practice nurse fee. Some health services provide this test at low or no cost. You can phone and ask or check fees on their website.
Your smear taker will let you know your results. This usually takes about two weeks. It does not mean anything is wrong if it takes longer:
- a normal result - everything is fine. Have a repeat test in three years.
- an unsatisfactory test result: the lab was unable to properly test your sample. This can happen for different reasons and does not mean that anything is wrong. You will usually be asked to repeat your test in 12 months.
- an abnormal result means that you have unusual changes that are usually caused by the HPV virus. Often these changes will go away on their own. Sometimes these need to be treated so they don’t turn in to cancer. You will usually be asked to have a repeat test in 12 months or referred to a specialist for further investigation and treatment.
Benefits and harms of cervical screening
The cervical screening test picks up most problems at an early stage. It has prevented many women from developing cervical cancer.
But it is not a perfect test. Some problems may be missed It is important to have regular tests, so they can be picked up the next time.
Sometimes cervical tests find things that will go away by themselves and will not cause you any health problems. This may mean some more tests.
Bowel cancer is one of the most common cancers in New Zealand.
Bowel screening tests look for early signs of cancer before it has developed and before you have any signs or symptoms. It can save your life.
If you are aged between 60-74 years, have your free bowel screen test every two years.
Some people are at higher risk of bowel cancer due to family history or because of some medical conditions. You may also need other tests/investigations, starting from a younger age. Talk to your doctor.
No screening test is perfect and there is a chance a cancer can be missed. That is why the test is repeated every two years.
People at any age (including young people) should visit their doctor if they have signs and symptoms of bowel cancer.
The bowel screening test
You do the test yourself at home. It is free if you are between 60 and 74 years.
Collect a tiny sample of your poo with a test stick, seal it in a tube and bag provided and send it to the lab.
The lab will look for very small amounts of blood. Many conditions can cause you to have blood in your poo (such as haemorrhoids/piles), or it can indicate if you have polyps or cancer. Polyps are small growths that can turn in to cancer over time. If blood is found, you will be sent for further investigation.
You get a letter with the results around three weeks later.
Most people get a negative result - everything is fine and you repeat the rest in two years if you are under 74 years.
A positive test means they have found blood in your poo. This does not necessarily mean you have cancer but you will need further tests.
Some people who have bowel symptoms and who have a negative FIT result may still require further tests, and so should discuss their symptoms with their doctor.
There is no national screening programme for prostate cancer in New Zealand, or any other country, as a suitable screening test is not yet available.
You can choose to have a PSA test.
Prostate-specific antigen or PSA is a protein produced by the prostate. The PSA test measures the amount of PSA in a sample of blood. Many men have a high PSA level. A high level does not always mean there is cancer.
Making a decision to get checked for prostate cancer is different for every man. Before making a decision, it's good to know the benefits and risks of getting checked.
We encourage you to talk to your doctor about PSA testing and there is an online tool to help your decision making:
You may or may not choose to have a PSA test based on this information.
Your doctor will support you to make an informed decision based on:
- The balance of benefits and harms of PSA testing and treatment. It is unclear if PSA screening affects the risk of dying of prostate cancer. Men may have unneeded treatment and have to cope with the related harms of this treatment.
- Your own preferences. You have the right to decide for yourself.
- Ethnicity. Māori men are less likely to be diagnosed but more likely to die from prostate cancer than non‐Māori men. Pasifika men also have a higher prostate cancer death rate.
- Age. Discussion on PSA testing with your doctor usually begins at around 50 years. PSA testing is not usually recommended for men 70 years and older. The harms are likely to be greater than the benefits.
- Your overall health.