Women’s experiences of the renewed National Cervical Screening Program in Australia 12 months following implementation: a qualitative study

Abstract

ObjectiveTo explore women’s experiences of the renewed National Cervical Screening Program in Australia from the perspective of women who have received different human papillomavirus (HPV) test results. Women aged 25 to 74 are now screened every 5 years with primary HPV screening.DesignQualitative interview study.SettingAustralia.ParticipantsWomen in Australia aged 25 to 74 who reported participating in cervical screening since December 2017, purposively sampled by test result (HPV positive, HPV negative and HPV status unknown).Methods26 interviews with women aged 25 to 74 were conducted and analysed thematically.ResultsThree main themes emerged: knowledge and attitudes about the programme changes, information dissemination, the meaning and responses to test results and the new cervical screening test (CST). Some women showed little awareness of the changes, but others understood that HPV is detected earlier than abnormal cells. Some expressed positive attitudes towards the CST and were not anxious about less frequent screening. Most women envisaged the changes would have minimal impact on their screening behaviour. Women mainly wanted more information about the changes and the possible results from the new CST. Overall women could recall their HPV results and understand the implications for future cervical screening. Anxiety about being at ‘increased risk’ was more apparent in women who were HPV positive without history of abnormal results.ConclusionsWomen show some understanding of HPV and the new CST, but more written and public communication about the changes and possible results are warranted. Efforts are needed to ensure that women who are HPV positive without history of abnormal results receive the information needed to alleviate anxiety.

He Tapu Te Whare Tangata (sacred house of humanity): Under‐screened Māori women talk about HPV self‐testing cervical screening clinical pathways

“…This is especially so for the delivery of positive HPV test results. As with the anxiety and fear associated with abnormal cervical smear test results, 24–27 positive HPV test results may cause adverse psychological and social repercussions, such as anxiety and stigmatization, especially when awareness about HPV is low 28,29 . The importance of culturally safe and empathetic care has been emphasized for Indigenous women 3,8,23 …”

“…As with the anxiety and fear associated with abnormal cervical smear test results, [24][25][26][27] positive HPV test results may cause adverse psychological and social repercussions, such as anxiety and stigmatization, especially when awareness about HPV is low. 28,29 The importance of culturally safe and empathetic care has been emphasized for Indigenous women. 3,8,23 A recent community-based cluster randomized controlled trial (cRCT) in Te Tai Tokerau (Northland), 23 Aotearoa, demonstrated an almost three-fold increase in screening among Māori women when offered HPV self-testing compared to usual care, with over 80% of women who received a positive result attending their colposcopy appointment.…”

What do South Asian immigrant women know about HPV, cervical cancer and its early detection: A cross-sectional Australian study

“…Among under-screened and never-screened women, HPV self-sampling may be the preferred screening option, as supported by a randomized controlled trial reporting increase in screening uptake using this approach ( Sultana et al., 2016 , Sultana et al., 2015 ). However, no study to date has assessed the knowledge of immigrant women of the renewed program or self-sampling option ( Dodd et al., 2020 , Nagendiram et al., 2020 ).…”

Reproductive health needs of Human papillomavirus (HPV) Positive women: A systematic review

“…To prevent anxiety and psychological distress, education and counseling are increasingly important for women diagnosed with HPV. Therefore, more attention should be paid to how to communicate and provide information (18-20).…”