Renewal of the National Cervical Screening Program: health professionals’ knowledge about screening of specific populations in NSW, Australia

Abstract

We surveyed health professionals conducting cervical screening in NSW, Australia, to better understand their knowledge of the renewed National Cervical Screening Program • Our study identified gaps in knowledge regarding screening for specific populations of women, including immunedeficient women, women who have had a hysterectomy, and those who have an indication for sample self-collection • Ongoing support is needed for health professionals to ensure translation of guidelines into practice

Perceptions and implications for cervical screening and self‐collection: A qualitative exploration of never and under‐screened Queensland women

“…28 Many practitioners also do not feel comfortable managing screening in women with special medical circumstances or increased risk. 29 Opportunities to screen with nonmedical cervical screening providers at family planning and other health care providers are underutilised. 29 Self-collected vaginal specimens are equally accurate for detecting HPV as a cervical sample.…”

“…29 Opportunities to screen with nonmedical cervical screening providers at family planning and other health care providers are underutilised. 29 Self-collected vaginal specimens are equally accurate for detecting HPV as a cervical sample. 5 However, since its implementation in Australia, self-collection has not been routinely offered by general practitioners (GPs) to women who meet the eligibility criteria.…”

“…After the changes to the NCSP in 2017, most practitioners understood the changes to test frequency and test type but had less familiarity with accessing patient history on the National Cancer Screening Register (NCSR) which is crucial to determining if a woman is never or under‐screened 28 . Many practitioners also do not feel comfortable managing screening in women with special medical circumstances or increased risk 29 . Opportunities to screen with nonmedical cervical screening providers at family planning and other health care providers are underutilised 29 …”

“…However, since its implementation in Australia, self‐collection has not been routinely offered by general practitioners (GPs) to women who meet the eligibility criteria 22 . This is partly because only certain pathology laboratories in Australia currently accept self‐collected samples, and partly due to GPs' reported confusion regarding eligibility and protocol for administering the test 28,29 . The current national cervical screening guidelines specify the need for self‐collection to be “facilitated by a healthcare professional” or “under the supervision of a healthcare professional.” Additionally, a NCSP Toolkit for engaging under and never‐screened women states that women should remain in the health service but be directed to a bathroom or behind a curtain in the consulting room.…”

Widening the offer of human papillomavirus self‐sampling to all women eligible for cervical screening: Make haste slowly

“…Further reducing the effectiveness of this implementation was the need to confirm eligibility in real‐time by looking up an individual woman's screening history, hindered by a delayed arrival of certain functionalities of the national screening register 34,50‐52 . This was compounded by underinvestment into promoting the availability of HPV self‐sampling as a new feature of the renewed national screening guidelines 51,52 and insufficient education and training for health care practitioners, among whom a significant proportion expressed lack of confidence and comfort in recommending self‐sampling to eligible women 52,54 . Although the Australian programme is now addressing these issues, 56 the learnings are highly instructive for other programmes.…”