Anna Adcock (New Zealand)
Victoria University of Wellington Centre for Women's Health ResearchPresenter of 2 Presentations
Innovation and Impact- Research Examples (ID 1702)
Webcast
HE TAPU TE WHARE TANGATA (THE SACRED HOUSE OF HUMANITY): EXPLORATION OF THE CERVICAL SCREENING CLINICAL PATHWAY FOLLOWING OFFER OF HPV SELF-TEST (ID 524)
Abstract
Introduction
Māori (Indigenous New Zealand) women experience inequities in cervical cancer morbidity and mortality. Human Papilloma Virus (HPV) causes the majority of cervical cancers and new technology means women can self-test for HPV using a vaginal swab. As part of a community RCT in rural New Zealand looking at the offer of a self-taken HPV swab for under-screened (no screen in 4+ years) Māori women, we are undertaking a qualitative sub-study to explore the journeys of these women. This study is ongoing with data collection finishing mid-2020.
Methods
A qualitative Kaupapa Māori (by Māori, for Māori) methodology is applied. Participants are interviewed by a female Māori researcher, who is experienced in appropriate rituals of encounter. Three groups of women are interviewed: swab declined, swab accepted negative result, and swab accepted positive hrHPV result with referral to colposcopy. Data are analysed using thematic analysis.
Results
Preliminary analysis (interviews with 20 participants) indicates several key themes. Women who declined were steeped in their beliefs that interventions are dangerous and were often scared of receiving a positive result. Women who accepted the swab all reported positive feedback citing privacy, quickness/ease, and convenience of the test. These women said that they will be more likely to re-screen using a self-test and encourage their female family members to screen too. Women referred to colposcopy were often scared and confused, and reported that they had been told their HPV result in an insensitive manner.
Conclusions
The lived realities for these women varied with the HPV self-test being accepted and valued as an option for screening by most. However, there is urgent need to upskill clinicians in their knowledge of HPV and the cervical screening pathway, and to implement a national public health campaign. This study has translational implications for upcoming changes to the New Zealand National Cervical Screening Programme.