Huge rise in cervical self-collection uptake

Morgan Liotta

25/01/2023 4:33:01 PM

But Dr Lara Roeske is still urging for stronger public health messages and support to help alleviate the extra onus placed on GPs.

GP talking to patient
Self-collection for cervical cancer screening enables dignity and control, according to Dr Lara Roeske.

After a slow start since its 1 July 2022 eligibility expansion, the uptake of self-collection for cervical cancer is steadily rising – with rates now up by over 400%.
According to MBS data for item 73071, there were only 2687 cervical tests self-collected in 2021.
From July 2022 when there were 1161 recorded for that month, the numbers continued to rise, until 5113 were recorded in November 2022, totalling 16,596 for the July–November period.
RACGP Board Chair Dr Lara Roeske, who sits on the National Cervical Screening Program (NCSP) Self-collection Implementation Committee, has been integral in helping to encourage participation and says she is witnessing a rising numbers of patients choosing self-collection.
‘Without fail I’m finding that most patients are really keen on the concept,’ she told newsGP.
‘They really like the idea of being able to do this themselves in their own privacy, of not having an intimate examination performed.
‘I’m initiating the conversation pretty well 100%, and out of every conversation over the last few months there’s only been one patient who felt that they would prefer that they have a cervical screening test done by me.’
When it comes to those conversations, Dr Roeske believes that GPs should emphasise that self-collection is as accurate as if the doctor performs it, and the end result of a negative test is one that will give them the same five-year recall interval.
‘Right at the outset, they’re very powerful messages around the accuracy and the evidence behind the tests that are exactly the same in terms of that outcome of a negative result, meaning you can go away for five years,’ she said.
While Dr Roeske is pleased with the numbers showing a steady rise in uptake, they ‘could be even better’, with stronger public health messages needed – a call she has been making since expansion of the self-collection option.
‘There has been insufficient information in terms of a public campaign really driving people to talk to their GP about self-collection,’ she said.
‘That’s the side of the equation that’s missing.
She recalls the ‘fantastic campaign’ around preventing cervical cancer when she was growing up: posters at train stations and bus stops about getting your Pap smear.
‘Have we seen the same degree of a cut-through engaging campaign on the sort of platforms that the target audience really engages with?’ she asks.
‘I would say that we probably haven’t … and there’s a lot of room for improvement there.’
Dr Roeske also raises the point that extra onus can fall on GPs to promote self-collection amid the lack of a targeted public health campaign.
‘There’s a huge reliance on general practice to carry a substantive proportion of the load of health promotion messaging in regard to self-collection being available,’ she said.
‘As we all know, there are many things the GP can be busy promoting in the health promotion education space.
‘There are many important components that make national programs successful, and … for GPs, it’s that we don’t shy away from our huge role of the forward-facing health promotion of active uptake [of self-collection].
‘Most importantly, what all GPs should be doing with anyone who’s eligible for cervical screening is giving them the option – not a discussion whether they will have this done, but you actually need to present the option and discuss it.’
As part of the NCSP, GPs have an ‘important relationship’ of working closely with the laboratories who process the tests, but Dr Roeske is concerned the onus also falls on general practices to determine whether their local laboratory does this or whether they need to send it on, as not all laboratories are accredited to test and interpret self-collected samples.
‘Then there are questions around when the results come back, etcetera,’ she said.
‘That is, pure and simple, a barrier to the business process of getting this sample taken, then interpreted and a result back … and we want to see improvement on that.’
Whether stronger, targeted public facing campaigns around self-collection are launched, the numbers verify that more people are choosing the option, which plays a part in Australia’s on-track target to eliminate cervical cancer by 2035.
Executive Director of the Australian Centre for the Prevention of Cervical Cancer Pathology and Pathology Awareness Australia Ambassador, Professor Marion Saville, echoes Dr Roeske in promoting the self-collection test for the prevention of cervical cancer.
‘Self-collection is expected to lead to a big uptick in cervical screening participation rates, and certainly we have seen a dramatic increase in the number of people accessing self-collection since July,’ Professor Saville said.
‘We hope this will translate into meaningful increases in screening participation rates.’
To enable further increases in cervical cancer screening participation rates, targeting under-screened people is important, including particular groups that self-collection will benefit, such as:

  • people who have experienced sexual violence and trauma
  • LGBTQI+ people
  • Aboriginal and Torres Strait Islander people
  • people from culturally and linguistically diverse and refugee communities
  • people living with disability.
‘The Self-collection Implementation Committee is looking at all the aspects of what makes the [NCSP] program successful across the board and across the country,’ Dr Roeske said.
‘We [need to] ensure that the different components are appropriately supporting and working together so that we get the best results for people in Australia eligible for screening.’
More information for GPs about self-collection as part of the National Cervical Screening Program is available on the Department of Health and Aged Care website.
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