Calls for stronger public health messages for cervical screening

Morgan Liotta

11/11/2022 4:17:32 PM

Despite Australia being on track to eliminate cervical cancer, knowledge gaps and barriers remain, particularly around self-collection.

GP speaking to patient about self-collection
Around a third of national survey respondents do not identify cervical cancer screening as a prevention strategy.

Over the past two decades, Australia has invested heavily in public health messages and the National Cervical Screening Program (NCSP) as it works towards the goal of eliminating the disease by 2035.
But while these efforts have Australia on track to achieve this goal, many people remain unclear on how they can help to reduce diagnoses.
According to a new poll, released by the Australian Cervical Cancer Foundation (ACCF) ahead of this year’s national awareness week, four out of five people are unaware that Australia could become the first country in the world to eliminate cervical cancer, while only half of the 1000 people surveyed believed they could play a role.
It also found that while the HPV vaccination is estimated to prevent up to 92% of infections responsible for almost 75% of cervical cancers, less than half (43%) of those surveyed do not believe vaccination could prevent the deadly disease.
ACCF CEO Vicky Darling says the results are concerning and highlight knowledge gaps.
‘[They] suggest that despite our best efforts, there may be a major gap in Australians’ understanding of the main cause of cervical cancer and how to prevent it,’ she said. 
‘We know our world-leading cervical cancer prevention programs work, but we can’t afford to become complacent and lose the focus or the momentum we have created.
‘We have the tools we need to eliminate cervical cancer readily accessible, but we need to continue with our national prevention programs and invest in public education to ensure we all understand the role we can play to help make cervical cancer history and that importantly, no one is left behind.’
It is estimated that 942 females will have been diagnosed with cervical cancer by the end of 2022, while it is predicted that 222 will be recorded this year. The majority (70%) of these cases occur in people who were not up to date with their screening or who had never screened before.
The NCSP is designed to identify HPV infections early before they become cervical cancer, and since its 1991 introduction, the program has halved the number of new cervical cancer diagnoses and the number of deaths from cervical cancer in people aged 25 or older.
However, 32% of respondents to ACCF’s national survey did not identify screening as a prevention strategy.
A potential ‘game-changer’ that could further increase participation rates is self-collection for cervical cancer screening, eligibility for which was expanded in July 2022.
However, reports of a ‘slow start’ to the uptake in general practice prompted GP Dr Lara Roeske, a member of the National Cervical Screening Program Self-Collection Implementation Committee, to call for improved public health messages to encourage people to see their GP about the new option.
‘Self-collection is being held back by the lack of public awareness that this option is now available to everyone who needs cervical cancer screening,’ Dr Roeske told newsGP.
‘There hasn’t been a big public-facing campaign to encourage people to see their GP and ask about self-collection, and we sorely need this.’
A national campaign has yet to materialise, but a number of localised campaigns were recently launched as part of National Cervical Cancer Awareness Week (7–13 November), raising hopes of increased participation.
In Victoria, the Australian Centre for the Prevention of Cervical Cancer (ACPCC) and Cancer Council Victoria are collaborating on a ‘Self-collection Saves Lives’ campaign, which aims to increase community and health practitioner awareness about self-collection.
‘Self-collection is one of the best tools we have available to increase cervical screening participation and put us on track to eliminate cervical cancer in Australia by 2035,’ ACPCC Executive Director Professor Marion Saville said.
‘HPV self-collection allows screening participants to take their own vaginal sample for HPV testing. It is an accurate and acceptable alternative to a clinician-collected cervical screening test via a speculum examination and has recently been made widely available as an option for all participants in the NCSP.’
Meanwhile, in South Australia, the ‘You Can Do It’ campaign was recently launched following consultation with the RACGP and the AMA. It also targets women and people with a cervix aged 25–74 to consider self-collection for their five yearly screening.
The campaign lead, Wellbeing SA, has also partnered with Cancer Council SA to fund training for GPs in self-collection to ensure women and people with a cervix are supported to choose the best option for cervical cancer screening.
SA Minister for Health and Wellbeing Chris Picton said the self-collection option provides people with a cervix more choice and control, with the new campaign aiming to ensure more regular testing for cervical cancer happens, which ‘will ultimately save lives’.
‘Self-collection is a game-changer for many women [and people with a cervix] who, for a variety of reasons, may be putting it off or never had a cervical screening test before,’ Minister Picton said.
The ACCF says it will continue to raise awareness of cervical cancer and ‘unite Australians to take action to help make cervical cancer history’.
Dr Roeske, a long-time advocate for self-collection, says it aligns with best practice in preventive health.
‘Self-collection addresses many of the barriers to traditional screening, allowing people control and dignity,’ she said.
‘It is a real game-changer in our fight against cervical cancer by increasing equitable access to screening for eligible Australians.’
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Dr Effie Parakilas   15/11/2022 7:43:14 AM

There are still restrictions for self-collection however so the message isn’t as simple as ‘go along and take your own sample’. You need to be at least two years overdue for your CST to be eligible…correct me if I’m wrong. A woman who decides, for whatever reason, to choose self-collection, and wants to do this self-collection, on time, every five years, doesn’t meet the eligibility criteria, according to my understanding.