Rachael H. Dodd (Australia)
The University of Sydney Faculty of Medicine and HealthPresenter of 3 Presentations
HEALTH PROFESSIONALS’ VIEWS AND EXPERIENCES OF THE RENEWED AUSTRALIAN CERVICAL SCREENING PROGRAM: 12 MONTHS INTO THE RENEWAL (ID 383)
Abstract
Introduction
Recent research has shown that women have concerns about the changes to the National Cervical Screening Program and health professionals are influential when changes to recommendations are required. Attitudes of health professionals practising in Australia since its implementation in December 2017 are unknown. This study explored the attitudes and experiences of health professionals practising in Australia towards the introduction of primary HPV screening.
Methods
Interviews were conducted with 31 health professionals involved in cervical screening during December 2018. This included general practitioners, obstetricians & gynaecologists, gynaecological oncologists, pathologists and nurses. The interviews were analysed using thematic analysis.
Results
Overall, health professionals had positive attitudes towards the renewed cervical screening program and introduction of primary HPV screening. These were focused around the availability for vaccination for all girls and boys and viewing the changes as a ‘real step forward’ with belief that the cervical screening test is a better test. Four main themes emerged from the data: practical system challenges, communication and education, finding ways around the guidelines and other ‘collateral’. Practical system challenges included increased colposcopy referrals, complex screening pathways and issues with self-collection. In terms of communication and education, the limited public education was recognised, in addition to challenges with particular age groups of women. Finding ways around the guidelines was exampled by over-referral of symptomatic tests and misinformed self-collection. Other ‘collateral’ was demonstrated through reduced opportunistic screening opportunities due to less frequent primary care presentations.
Conclusions
Women’s understanding and experience of the renewed National Cervical Screening Program will likely depend upon clinicians’ ability and willingness to explain the rationale behind the changes, and to respond confidently to patient concerns regarding these changes. It is essential that concerns and challenges identified in this study are addressed with clinicians to improve implementation of primary HPV screening programs.
WOMEN EXPERIENCES OF THE RENEWED NATIONAL CERVICAL SCREENING PROGRAM IN AUSTRALIA 12 MONTHS FOLLOWING IMPLEMENTATION (ID 389)
Abstract
Introduction
Most research to date exploring women’s views and experiences of the Renewal of the Australian National Cervical Screening Program (NCSP) was conducted prior to their implementation. This study aimed to explore women’s experiences of the renewed NCSP, from the perspective of women who have received different HPV test results.
Methods
Qualitative interviews were conducted with a sample of women in Australia aged 25 – 74 years who received cervical screening since December 2017.
Results
26 women were interviewed. Four main themes emerged: 1) knowledge and attitudes about the changes: some lack of awareness of the changes was still evident, but others that understood that HPV is detected earlier than abnormal cells and HPV is common, expressed positive attitudes towards the test and felt less anxious due to less frequent screening; 2) information dissemination: almost all women wanted more information about both the changes and the possible results from the new cervical screening test; 3) screening behaviour and experiences: some women trusted the reasons behind the changes and had postponed their cervical screen until the changes had been implemented following their doctor’s advice. Most women envisaged the NCSP changes would have minimal impact on their screening behaviour and; 4) focus on meaning of results and the new test: overall women were able to recall their HPV results and understand the implications for future cervical screening. Women with no previous history of abnormal smears were somewhat anxious if they received HPV+ results, whereas those with previous history were less fazed.
Conclusions
Women show some understanding of HPV and the new cervical screening test, but more written information and public communication about the changes and possible results are warranted. In particular, efforts are needed to improve information for women who are HPV+ with no history of abnormal results receive the information they need to alleviate anxiety.