Two years after the World Health Organisation (WHO) announced its goal to eliminate cervical cancer as a public health problem, medical experts in Australia fear that some women in marginalised groups are not screening or avoiding it due to a lack of awareness of the new private self-collection cervical cancer screening option available through their health professional.
Australian women in under-screened communities, including Aboriginal and Torres Strait Islander people, those living regionally, culturally and linguistically diverse communities, LGBTIQ+ people and people with disabilities — are being urged to take the self-collection option at a doctor’s clinic in order for Australia to meet the WHO target by 2035.
Experts believe the self-collection option will increase screening participation rates across the country.
Professor Marion Saville, Executive Director at the Australian Centre for the Prevention of Cervical Cancer, said more than seventy per cent of cervical cancer cases “occur in women who are either overdue for screening or who have never been screened.”
One study published last year revealed that cervical cancer incidence had to reduce by 74 per cent in Indigenous women in Australia before the 2035 cervical cancer elimination target could be reached.
According to the same study, Aboriginal and Torres Strait Islander women experience cervical cancer at the same rates as developing parts of the world, despite having access to vaccination and screening programs.
Cervical cancer occurs when abnormal cells grow in the lining of the cervix.
The incidence of cervical cancer has dropped significantly since the National Cervical Screening Program started in 1991 and the national Human Papilloma Virus (HPV) vaccine program commenced in 2007.
According to Cancer Australia, more than 900 women and people with a cervix will be diagnosed with cervical cancer this year alone, while more than 200 people will die from it.
A recent study conducted by the University of Queensland found that among South Asian immigrant women in Australia, less than half knew that HPV could cause cervical cancer. The same group of women also showed little awareness about Pap and HPV tests.
Only a third of participants were aware of the changes made to the cervical screening program, and just 10 per cent knew about the availability of the self-sampling option introduced in the new screening program.
Professor Saville said women, especially between the ages of 25 and 29 or in these groups, were not participating in the screening program in the numbers she would like to see.
“It’s important to encourage all women, especially younger women, to participate, as they are not completely immune from the disease with the HPV vaccination they received in high school,” she said.
“Self-collection is much less invasive and uncomfortable than the current speculum collection performed by a healthcare professional, which some women find embarrassing and avoid altogether.”
“As such, self-collection will help remove some of the cultural and personal barriers that have previously discouraged women from screening. Cervical cancer is preventable, and elimination is within reach if we act now.”
The Federal Government hopes that by giving women the self-collect option, Australia can reach its goal to eliminate cervical cancer as a public health problem.
Australia is a global leader in preventing cervical cancer, with its HPV vaccination program delivered through schools, and a longstanding cervical screening program.
Earlier this year, the national self-collection program was broadened to include all women aged between 25 and 74.
Unfortunately, COVID disturbed many people’s plans to screen.
“People who were due to have their screening test in 2020 are more likely, due to COVID restrictions, to be overdue and face challenges for screening,” Professor Saville said.
Allison Rossiter, Managing Director of Roche Diagnostics Australia — a leading supplier of the HPV test, said her company is committed to supporting the government to reduce and eliminate cervical cancer through expanded self-collection and greater access to all eligible people.
“Our HPV tests are the most widely available in Australia,” she said. “The test is included on the ARTG to provide individual results for HPV genotypes 16 and 18, the two highest risk types known to be the primary cause of cervical cancer. By providing individual results, clinicians can better risk-stratify patients, and make patient management decisions with confidence.”