National Cervical Screening Program renewal in Australia: survey of clinician views and attitudes
Sally Sweeney A C , Yan Cheng A , Jessica R. Botfield A and Deborah Bateson BA Family Planning NSW, 328–336 Liverpool Road, Ashfield, NSW 2131, Australia.
B Discipline of Obstetrics, Gynaecology and Neonatology, University of Sydney, Camperdown, NSW 2050, Australia.
C Corresponding author. Email: sallys@fpnsw.org.au
Australian Journal of Primary Health 26(5) 410-416 https://doi.org/10.1071/PY20032
Submitted: 12 February 2020 Accepted: 10 August 2020 Published: 29 September 2020
Abstract
From 1 December 2017, the National Cervical Screening Program was renewed in Australia, with updated national cervical screening guidelines released. This study was performed to determine clinicians’ familiarity with the updated guidelines and explore their views and attitudes towards the renewed program. Clinicians providing cervical screening in New South Wales, Australia, were invited to complete an online survey in 2018. Of the 241 clinicians who responded, 91.5% supported the change to 5-yearly human papillomavirus screening from the age of 25 years. However, nearly 13% indicated they did not know where to access the renewed guidelines and 37% had never or rarely accessed them. Open-ended responses highlighted clinicians’ concerns about missed cancers and missed opportunities for health checks. Those raising these concerns accessed the guidelines less frequently. The findings highlight important areas for additional education and support for clinicians in translating guidelines into practice to ensure successful delivery of the renewed program.
Keywords: health services: needs and demands, patient-centred care, primary health care, social support, women’s health services.
References
Australian Institute of Health and Welfare (AIHW) (2015) Australian Cancer Database 2015. (AIHW: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/reports/cancer-screening/cervical-screening-in-australia-2019/data [Verified 9 January 2020]Australian Institute of Health and Welfare (AIHW) (2019) Cervical screening in Australia 2019. Cat. no. CAN 124. (AIHW: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/reports/cancer-screening/cervical-screening-in-australia-2019 [Verified 17 September 2020]
Bateson D, Garrett A, Hammond I, Roeske L, Whop L, Wrede CD (2015) 15. Screening in women who experienced early sexual intercourse or have been victims of sexual abuse. In ‘National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding’. (Cancer Council Australia: Sydney, NSW, Australia) Available at https://wiki.cancer.org.au/australiawiki/index.php?oldid=190235 [Verified 12 September 2019]
Cancer Council Australia Cervical Cancer Screening Guidelines Working Party (2018) Self-collected vaginal samples. In ‘National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding’. (Cancer Council Australia: Sydney, NSW, Australia) Available at https://wiki.cancer.org.au/australiawiki/index.php?oldid=190203 [Verified 11 September 2019]
Canfell K, Hammond I, Saville M, Cancer Council Australia Cervical Cancer Screening Guidelines Working Party (2018) 5. Benefits, harms and cost-effectiveness of cervical screening in the renewed National Cervical Screening Program (NCSP). In ‘National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding’. (Cancer Council Australia: Sydney, NSW, Australia) Available at https://wiki.cancer.org.au/australiawiki/index.php?oldid=190197 [Verified 15 October 2019]
Denham O, Garland SM, Gorelik A, Ogilvie G, Tan J, Mazza D, Wrede CDH, McBride B, Jayasinghe Y (2016) Attitudes to changes in cervical screening guidelines: preliminary views of Australian general practitioners and nurse practitioners. Journal of Family Medicine and Disease Prevention 2, 041
| Attitudes to changes in cervical screening guidelines: preliminary views of Australian general practitioners and nurse practitioners.Crossref | GoogleScholarGoogle Scholar |
Farnsworth A (2014) Changes to cervical screening in Australia: applying lessons learnt. Medical Journal of Australia 201, 245–246.
Francke AL, Smit MC, de Veer AJE, Mistiaen P (2008) Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC Medical Informatics and Decision Making 8, 38
| Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review.Crossref | GoogleScholarGoogle Scholar | 18789150PubMed |
Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H (1998) Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ (Clinical Research Ed.) 317, 858–861.
| Attributes of clinical guidelines that influence use of guidelines in general practice: observational study.Crossref | GoogleScholarGoogle Scholar |
Hammond I, Saville M, Cancer Council Australia Cervical Cancer Screening Guidelines Working Party (2018) Introduction. In ‘National Cervical Screening Program: guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding’. (Cancer Council Australia: Sydney, NSW, Australia) Available at https://wiki.cancer.org.au/australiawiki/index.php?oldid=190186 [Verified 11 September 2019]
Jayasinghe Y, Rangiah C, Gorelik A, Ogilvie G, Wark JD, Hartley S, Garland SM (2016) Primary HPV DNA based cervical cancer screening at age 25 years: views of young Australian women aged 16–28 years. Journal of Clinical Virology 76, S74–S80.
| Primary HPV DNA based cervical cancer screening at age 25 years: views of young Australian women aged 16–28 years.Crossref | GoogleScholarGoogle Scholar | 26589584PubMed |
Lugtenberg M, Zegers-Van Schaik J, Westert G, Burgers J (2009) Why don’t physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners. BMC Implementation Science 4, 54
| Why don’t physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners.Crossref | GoogleScholarGoogle Scholar |
Machalek DA, Roberts JM, Garland SM, Thurloe J, Richards A, Chambers I, Sivertsen T, Farnsworth A (2019) Routine cervical screening by primary HPV testing: early findings in the renewed National Cervical Screening Program. Medical Journal of Australia 211, 113–119.
| Routine cervical screening by primary HPV testing: early findings in the renewed National Cervical Screening Program.Crossref | GoogleScholarGoogle Scholar | 31168828PubMed |
Medical Services Advisory Committee (MSAC) (2014) Renewal of the National Cervical Screening Program Public Summary Document. (Australian Government: Canberra, ACT, Australia) Available at http://www.msac.gov.au/internet/msac/publishing.nsf/Content/D924E2F768B13C4BCA25801000123B9E/$File/1276%20-%20Final%20MSAC%20PSD%20-%20NCSP%20Renewal.pdf [Verified 16 January 2020]
Obermair HM, Dodd RH, Bonner C, Jansen J, McCaffery K (2018) ‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia. BMJ Open 8, e019171
| ‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia.Crossref | GoogleScholarGoogle Scholar | 29440214PubMed |
Osborne SL, Tabrizi SN, Brotherton JML, Cornall AM, Wark JD, Wrede CD, Jayasinghe Y, Gertig DM, Pitts MK, Garland SM (2015) Assessing human papillomavirus genotype prevalence in young Australian women following the introduction of a national vaccination program. Vaccine 33, 201–208.
| Assessing human papillomavirus genotype prevalence in young Australian women following the introduction of a national vaccination program.Crossref | GoogleScholarGoogle Scholar | 25444787PubMed |
Roeske L (2018) A new era in cervical cancer prevention. AJGP 47, 405
Sasieni P, Castanon A, Cuzick J (2009) Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ 339, b2968
| Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data.Crossref | GoogleScholarGoogle Scholar | 19638651PubMed |
Smith M, Canfell K (2016) Impact of the National Cervical Screening Program in women of different ages. Medical Journal of Australia 205, 359–364.
Smith M, Hammond I, Saville M (2019) Lessons from the renewal of the National Cervical Screening Program in Australia. Public Health Research & Practice 29, 1–6.
| Lessons from the renewal of the National Cervical Screening Program in Australia.Crossref | GoogleScholarGoogle Scholar |
Yap D, Liang X, Garland SM, Hartley S, Gorelik A, Ogilvie G, Tan J, Wrede CDH, Jayasinghe Y (2016) Clinicians attitude towards changes in Australian National Cervical Screening Program. Journal of Clinical Virology 76, S81–S87.
| Clinicians attitude towards changes in Australian National Cervical Screening Program.Crossref | GoogleScholarGoogle Scholar | 26651602PubMed |