Professor Bev Lawton
Screening for high-risk human papillomavirus (HPV) with appropriate subsequent treatment in combination with a programme of vaccination against HPV could prevent nearly all cervical cancers.
In New Zealand, the National Cervical Screening Programme (NCSP) has been successful at reducing cervical cancer cases and deaths; however, the health outcome improvements are not shared equally across the population and around 55 people are still dying of this preventable cancer every year.
Research funded by the HRC from teams led by Professor Bev Lawton ONZM (Ngāti Porou), Victoria University of Wellington and Professor John Potter (Massey University) have been instrumental in the National Screening Unit’s plans to introduce HPV testing into the National Cervical Screening Programme.
HPV testing as a screen is more effective than cytology (the traditional Pap smear exam) at preventing cervical cancer and women can do it themselves.
Self-testing to obtain a sample for HPV is also as effective as sampling by a doctor or nurse and has been shown internationally to improve cervical screening participation, but the acceptability and uptake for women in New Zealand who did not participate in the national screening programme was unknown.
Professor Lawton led a community-based randomised control trial in partnership with primary care and Māori communities that compared usual care with an HPV self-testing programme for Māori women in rural or small urban environments. Women were opportunistically offered screening through community outreach at clinics, community centres, or home, by a trusted kaiāwhina, nurse, or doctor.
In a different study, Professor Potter and team conducted a community-based randomised controlled trial to investigate whether self-sampling increases screening participation among un- or under-screened Māori, Pacific, and Asian women in Auckland.
“This research has led directly to improvements in the uptake of screening for the human papillomavirus (HPV), the main cause of cervical cancer. Self-testing for HPV is now the preferred option for about 82% of New Zealand women undergoing cervical screening.”
Professor Lawton found a nearly three times increase of uptake of screening in un- or under-screened Māori women who were offered HPV self-testing compared to the control group, while Professor Potter’s work showed that self-sampling was preferred almost 10-fold by Māori and five- to six-fold by Asian and Pacific women over a standard Pap smear (a healthcare provider collected sample); these non-European women were the least served by the screening programme then in place.
Professors Lawton and Potter say this research has directly addressed barriers to access for communities of women with high health needs.
In May 2026, the findings of Professor Lawton and her team’s second randomised controlled trial, funded by the HRC and the Ministry of Health, to test if universal HPV self-testing for cervical screening increased screening coverage compared with usual care (cytology using a speculum) were published in the Lancet Obstetrics, Gynaecology, & Women’s Health 1. The results show that switching to a universal offer of HPV self-testing increases screen uptake for all eligible people, not just those who are under-screened, a finding that will have global impact.
The evidence generated from these trials directly informed the major change to the National Cervical Screening Programme seen in September 2023 with the introduction of HPV as the primary test and the new option of self-swabbing.
Between September 2023 and September 2025, 794,000 people had their HPV screening check, with approximately 82% using self-tests2. The introduction of HPV self-testing has seen the number of HPV tests returned increase from approximately 30,000 per month before launch of self-testing to 50,000 per month after launch. Since September 2023, overall HPV screening coverage has increased by 11%, with relative increases of 19% for Māori and 34% for Pasifika3.
1 Lawton B, Gibson M, Slater T et all. Primary cervical screening using a universal offer of human papillomavirus self-testing versus usual care in Aotearoa New Zealand: a cluster-randomised, non-inferiority trial. The Lancet Obstetrics, Gynaecology, & Women’s Health, 2026; 2, e425-e434
2 Te Whatu Ora Health New Zealand
3 Te Whatu Ora Health New Zealand and National Kaitiaki Group
The HRC has funded six contracts to a total of $5.1 million in HPV self-testing and follow up treatment since 2016.