Performance Indicator 13: Time to colposcopy
Summary time to colposcopy data
For participants aged 25–74 who were referred for colposcopy in 2023, the median time to colposcopy was 79 days.
Time to colposcopy
Definition
Participants aged 25–74 who have a screening or follow-up episode result that places them at higher risk of significant cervical abnormality, the time between the screening or follow-up result and colposcopy, measured as median and 90th percentile values, as well as within specified timeframes.
Rationale
Participants who receive a screening episode result or follow-up episode result that places them at higher risk of significant cervical abnormality will be referred to colposcopy. The recommended timeframes in which they should undergo colposcopic assessment is as per the NCSP Guidelines (Cancer Council Australia and Cervical Cancer Screening Guidelines Working Party). Monitoring actual time between screening result or follow-up result and colposcopy provides important information as to whether participants are receiving timely assessment, as delay in assessment may lead to poorer outcomes.
Data considerations
Colposcopy is the examination of the cervix using a magnifying instrument called a colposcope and is the first step in the assessment stage of the screening pathway.
Prior to 1 February 2021, there were three groups of higher risk participants – two based on primary screening episode results and one based on the follow-up HPV test performed 12 months following an intermediate risk primary screening episode.
Since 1 February 2021, there are four groups of higher risk participants – the same two based on primary screening episode results, one based on the first follow-up screening episode results (including those that would otherwise be intermediate risk but are assigned to higher risk due to being under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over), and one based on the second follow-up screening episode.
Guide to interpretation
A shorter time to colposcopy is better.
This performance indicator is based on primary screening tests performed in 2023.
This allows 12 months to 31 December 2024 to calculate time to colposcopy, and a further 6 months to 30 June 2025 to ensure that colposcopy and histology data to 31 December 2024 are complete.
Results
Time to colposcopy was calculated for the same four groups of participants aged 25–74 for whom a colposcopy rate was calculated.
The median time to colposcopy for each group is shown in Table 13.1.
The median time to colposcopy was:
- 61 days for participants whose primary screening test detected oncogenic HPV 16/18
- 51 days for participants whose primary screening test detected oncogenic HPV (not 16/18) and whose LBC test result was a high-grade squamous or any glandular abnormality
- 181 days for participants whose first follow-up HPV test detected oncogenic HPV 16/18 or whose first follow-up HPV test detected oncogenic HPV (not 16/18) and whose reflex LBC test result was a high-grade squamous abnormality, squamous cell carcinoma, or a glandular abnormality (or whose first follow-up HPV test result was oncogenic HPV (not 16/18) and whose reflex LBC test result was negative or a low-grade squamous abnormality and were under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over)
- 95 days for participants whose second follow-up test detected any oncogenic HPV.
For all participants aged 25–74 who were referred for colposcopy in 2023, the median time to colposcopy was 79 days.
The lowest median time to colposcopy was observed in participants who had an LBC that confirmed a high-grade abnormality. This aligns with the clinical guidelines, in which the recommended time to colposcopy is driven by the LBC result (for example, within 2 weeks for an LBC test result that indicates that cancer is present, and within 8 weeks for an LBC test result that indicates that a high-grade squamous abnormality is present).
Screening or follow-up result | Median (days) | 90th percentile |
|---|---|---|
Primary screening test HPV 16/18 + any LBC | 61 | 225 |
Primary screening test HPV (not 16/18) + high-grade/glandular LBC | 51 | 145 |
First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC | 181 | 561 |
Second follow-up test any HPV + any LBC | 95 | 446 |
Total | 79 | 439 |
Note: First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC additionally includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.
Source: AIHW analysis of NCSR data (NCSR RDE 11/07/2025).
Time to colposcopy as proportion who had a colposcopy within 26 weeks
Time to colposcopy was also calculated as the proportion of participants who had a colposcopy within 4 weeks, 8 weeks, 12 weeks, and 26 weeks (Figure 13.1).
At 26 weeks after their higher risk screening episode or follow-up episode:
- 80.9% of participants whose primary screening test detected oncogenic HPV 16/18 had a colposcopy
- 89.4% of participants whose primary screening test detected oncogenic HPV (not 16/18) and whose reflex LBC test result was a high-grade squamous abnormality, squamous cell carcinoma, or a glandular abnormality had a colposcopy
- 33.9% of participants whose first follow-up HPV test result was oncogenic HPV 16/18 or whose first follow-up HPV test result was oncogenic HPV (not 16/18) and whose reflex LBC test result was a high-grade squamous abnormality, squamous cell carcinoma, or a glandular abnormality (or whose first follow-up HPV test result was oncogenic HPV (not 16/18) and whose reflex LBC test result was negative or a low-grade squamous abnormality and were under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over) had a colposcopy
- 61.2% of participants whose second follow-up HPV test result was any HPV had a colposcopy.
Overall, 63.2% of participants aged 25–74 whose screening or follow-up test result in 2023 indicated that they should attend colposcopy, had a colposcopy within 26 weeks of their screening or follow-up test.
Figure 13.1: Proportion of participants who had a colposcopy within 4 weeks, 8 weeks, 12 weeks, and 26 weeks, by screening or follow-up result, participants aged 25–74, 2023
Note: First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC additionally includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.
Source: AIHW analysis of NCSR data (NCSR RDE 11/07/2025). Data and notes for this figure available in Table A13.1.
Time to colposcopy by age
The median number of days to colposcopy is shown by age for each of the four groups of participants referred for colposcopy in Figure 13.2.
Figure 13.2: Time to colposcopy, by screening or follow-up result, by age, 2023
Note: First follow-up test HPV 16/18 + any LBC or HPV (not 16/18) + high-grade/glandular LBC additionally includes first follow-up test HPV (not 16/18) + negative/low-grade LBC in participants who are under-screened, Aboriginal and/or Torres Strait Islander, or aged 50 or over.
Source: AIHW analysis of NCSR data (NCSR RDE 11/07/2025). Data and notes for this figure available in Table A13.2.
Time to colposcopy trends
The median time to colposcopy for higher risk participants has increased over time, in line with the decrease in colposcopy rate. The median time to colposcopy increased from 57 days in 2018 to 69 days in 2019 and 65 days in 2020. Following the introduction of a second follow-up episode and the addition of a new higher risk group, the median time to colposcopy increased to 73 days in 2021, thereafter increasing further to 87 days in 2022 before decreasing to 79 days in 2023 (Figure 13.3).
Figure 13.3: Median number of days to colposcopy, by year, participants aged 25–74, 2018 to 2023
Source: AIHW analysis of NCSR data (NCSR RDE 11/07/2025). Data and notes for this figure available in Table A13.4.