HPV self-collection: Are you ready to support the choice?

In September, a national campaign promoting choice in cervical screening, including self-collection, is set to launch.
 
The campaign will be the first of this scale in more than 20 years and is expected to result in a substantial increase in patient demand for self-collection.
 
According to Professor Marion Saville, Executive Director of the Australian Centre for the Prevention of Cervical Cancer (ACPCC), now is the time for practices to contact their laboratories to ensure they are prepared to offer self-collection as a choice for all patients.
 
She also says the campaign is a good reminder for GPs to ensure they are up to date with the latest information as they are at the front line of cervical cancer elimination.
 
‘One of the best things GPs can do is to introduce both cervical screening options to all eligible patients and support them to make an informed choice,’ she said.
 
‘Contact your laboratory to ensure you have the correct equipment and instructions for offering self-collection.’
 
Help make cervical screening equitable
More than 70% of cervical cancer cases in Australia occur in people who have never been screened or are overdue, making under-screening the main risk factor.
 
Aboriginal and Torres Strait Islander patients and patients with culturally and linguistically diverse backgrounds, among other groups, are less likely to participate in cervical screening due to several barriers, most notably having a speculum examination. Consequently, they are at additional risk of developing cervical cancer.
 
Available data indicates Aboriginal and/or Torres Strait Islander women have over twice the incidence and almost four times the mortality associated with cervical cancer compared with other Australians.
 
Evidence also suggests those born overseas are more likely to have never-screened or be overdue for screening, while being less likely to have heard of the option to self-collect. Data shows that those from some CALD backgrounds also have higher cancer rates.
 
Self-collection is highly acceptable to Aboriginal people and can facilitate the engagement of those who would otherwise not participate in screening. Study participants described the self-collection process as empowering, supporting bodily autonomy, easy to do, convenient, and less embarrassing than a speculum examination. Some, however, still preferred to screen with a clinician-collected test.
 
Similarly, self-collection can help address privacy concerns, as well as relieve fears of discomfort and pain in patients with CALD backgrounds.
 
Self-collection therefore presents a unique opportunity to address barriers, directly affecting cervical screening disparities.
 
The latest data
Self-collection has been embraced by patients and GPs since the program expanded in July 2022, to the point where over a quarter of all cervical screening tests processed in Australia from October to December 2023 were self-collected.
 
Self-collected samples are just as sensitive for the detection of detection of CIN2+/adenocarcinoma in situ and oncogenic HPV as clinician-collected samples. Furthermore, self-collection is one of the best tools GPs have in advancing the equitable elimination of cervical cancer.
 
Australia has just reached the 2030 WHO targets for cervical screening coverage, meaning we are well on the way to eliminating cervical cancer by 2035. However, there is still more work to be done in advancing equity in screening.
 
GP calls to action
GPs can get up to date guidance on self-collection through the ACPCC website.
 
It houses provider resources, patient how-to guides (including translated versions), and CPD learning opportunities, including RACGP-accredited online learning modules and upcoming webinars, addressing common clinician questions, management options for abnormal self-collection results, upcoming changes to the National Cervical Screening Program clinical guidelines, and more.
 
These webinars, presented by Professor Marion Saville, are RACGP CPD Approved for 1 Educational Activity hour (activity no. 859881). Register online.
 
This article was commissioned by the ACPCC and independently reviewed by newsGP.
 
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