Awareness and attitudes towards the revised National Cervical Screening Program amongst women in rural New South Wales: a cross-sectional study
Elizabeth Gosbell A # , Alisha Panambalana A # , Annabelle Stephenson A # , Carissa Vici A # , Tegan Dutton A and Jannine Bailey A *A Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, NSW 2795, Australia.
Australian Journal of Primary Health 29(5) 471-479 https://doi.org/10.1071/PY22267
Submitted: 8 December 2022 Accepted: 6 March 2023 Published: 11 April 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Research exploring awareness and attitudes towards the revised National Cervical Screening Program (NCSP) amongst rural Australian women is limited. Given the increased incidence and mortality from cervical cancer in rural Australian women, this gap needs attention. This study examined awareness and attitudes of women in rural New South Wales (NSW) towards the revised NCSP.
Methods: A cross-sectional survey was conducted with women aged 18–74 years currently residing in the Western NSW Primary Health Network region. The anonymous survey was distributed online via social media and email to eligible women.
Results: In total, 309 rural women participated. The majority were 30–39 years old (35.9%) and had completed tertiary education (73.1%), figures which are higher than average for this rural region. Of these, 51.8% (160/309) were aware there had been a change to the NCSP. This information most commonly came from their healthcare provider (57.5%; 82/160). Three-quarters reported being happy or neutral with the change (76.1%; 235/309). Those who were aware of the revised NCSP were more likely to have a positive attitude toward it (P = 0.02). Fewer participants reported that they were never/unlikely to participate in screening under the revised NCSP (4.8%, 9/309) as compared to the previous program (15.5%, 48/309) after being provided with information about the revised NCSP. Women who reported an abnormal result under the previous NCSP were more likely to be concerned about the revised NCSP (P = 0.037), in particular the starting age of 25 years (P = 0.007) and the 5-yearly screening interval (P = 0.008).
Conclusion: Awareness and knowledge levels play an important role in attitudes towards the revised NCSP in rural women. Strategies to increase participation rates should therefore target these areas. Healthcare professionals can take a central role in this information sharing process.
Keywords: awareness, cancer, cervical, human papillomavirus, knowledge, prevention, rural and remote, screening, women.
References
Atere-Roberts J, Smith JL, Hall IJ (2020) Interventions to increase breast and cervical cancer screening uptake among rural women: a scoping review. Cancer Causes & Control 31, 965–977.| Interventions to increase breast and cervical cancer screening uptake among rural women: a scoping review.Crossref | GoogleScholarGoogle Scholar |
Australian Government Department of Health and Aged Care (2022) About the National Cervical Screening Program. (Australian Government Department of Health and Aged Care: Canberra, ACT, Australia). Available at https://www.health.gov.au/initiatives-and-programs/national-cervical-screening-program/about-the-national-cervical-screening-program [Verified 16 November 2022]
Australian Institute of Health and Welfare (2019) Cervical screening in Australia 2019. (Australian Institute of Health and Welfare: Canberra, ACT, Australia). Available at https://www.aihw.gov.au/reports/cancer-screening/cervical-screening-in-australia-2019/summary [Verified 16 November 2022]
Azar D, Murphy M, Fishman A, Sewell L, Barnes M, Proposch A (2022) Barriers and facilitators to participation in breast, bowel and cervical cancer screening in rural Victoria: a qualitative study. Health Promotion Journal of Australia 33, 272–281.
| Barriers and facilitators to participation in breast, bowel and cervical cancer screening in rural Victoria: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
Clay JM, Daggy JK, Fluellen S, Tucker Edmonds B (2019) Patient knowledge and attitudes toward cervical cancer screening after the 2012 screening guidelines. Patient Education and Counseling 102, 411–415.
| Patient knowledge and attitudes toward cervical cancer screening after the 2012 screening guidelines.Crossref | GoogleScholarGoogle Scholar |
Dodd RH, Obermair HM, McCaffery KJ (2019) A thematic analysis of attitudes toward changes to cervical screening in Australia. JMIR Cancer 5, e12307
| A thematic analysis of attitudes toward changes to cervical screening in Australia.Crossref | GoogleScholarGoogle Scholar |
Dutton T, Marjoram J, Burgess S, et al. (2020) Uptake and acceptability of human papillomavirus self-sampling in rural and remote aboriginal communities: evaluation of a nurse-led community engagement model. BMC Health Services Research 20, 398
| Uptake and acceptability of human papillomavirus self-sampling in rural and remote aboriginal communities: evaluation of a nurse-led community engagement model.Crossref | GoogleScholarGoogle Scholar |
Foo YM, Goswami P, Grogin J, Hargan E, Thangarajah M, Dutton T, Mendel S, Bailey J (2021) Incorporation of human papillomavirus self-sampling into the revised National Cervical Screening Program: a qualitative study of GP experiences and attitudes in rural New South Wales. Australian Journal of Primary Health 27, 284–290.
| Incorporation of human papillomavirus self-sampling into the revised National Cervical Screening Program: a qualitative study of GP experiences and attitudes in rural New South Wales.Crossref | GoogleScholarGoogle Scholar |
Hall MT, Simms KT, Lew J-B, Smith MA, Saville M, Canfell K (2018) Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017–2035: example from Australia. PLoS ONE 13, e0185332
| Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017–2035: example from Australia.Crossref | GoogleScholarGoogle Scholar |
Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qualitative Health Research 15, 1277–1288.
| Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar |
Jayasinghe Y, Rangiah C, Gorelik A, et al. (2016) Primary HPV DNA based cervical cancer screening at 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 25 years: views of young Australian women aged 16–28 years.Crossref | GoogleScholarGoogle Scholar |
McRae J, Martin C, O’Leary J, Sharp L (2014) “If you can’t treat HPV, why test for it?” Women’s attitudes to the changing face of cervical cancer prevention: a focus group study. BMC Women’s Health 14, 64
| “If you can’t treat HPV, why test for it?” Women’s attitudes to the changing face of cervical cancer prevention: a focus group study.Crossref | GoogleScholarGoogle Scholar |
Nagendiram A, Bidgood R, Banks J, Heal C (2020a) Knowledge and perspectives of the new national cervical screening program: a qualitative interview study of north queensland women – ‘I could be that one percent’. BMJ Open 10, e034483
| Knowledge and perspectives of the new national cervical screening program: a qualitative interview study of north queensland women – ‘I could be that one percent’.Crossref | GoogleScholarGoogle Scholar |
Nagendiram A, Bougher H, Banks J, Hall L, Heal C (2020b) Australian women’s self-perceived barriers to participation in cervical cancer screening: a systematic review. Health Promotion Journal of Australia 31, 343–353.
| Australian women’s self-perceived barriers to participation in cervical cancer screening: a systematic review.Crossref | GoogleScholarGoogle Scholar |
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 |
O’Connor M, Costello L, Murphy J, et al. (2014) ‘I don’t care whether it’s HPV or ABC, I just want to know if I have cancer.’ Factors influencing women’s emotional responses to undergoing human papillomavirus testing in routine management in cervical screening: a qualitative study. BJOG: An International Journal of Obstetrics and Gynaecology 121, 1421–1430.
| ‘I don’t care whether it’s HPV or ABC, I just want to know if I have cancer.’ Factors influencing women’s emotional responses to undergoing human papillomavirus testing in routine management in cervical screening: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
Patel H, Moss EL, Sherman SM (2018) HPV primary cervical screening in England: women’s awareness and attitudes. Psycho-Oncology 27, 1559–1564.
| HPV primary cervical screening in England: women’s awareness and attitudes.Crossref | GoogleScholarGoogle Scholar |
Royal Australian College of General Practitioners (2021) Early Detection of Cancers – Cervical Cancer. (RACGP, East Melbourne, Vic., Australia). Available at https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/guidelines-for-preventive-activities-in-general-pr/early-detection-of-cancers/cervical-cancer [Verified 3 April 2023]
Smith M, Hammond I, Saville M (2019) Lessons from the renewal of the National Cervical Screening Program in Australia. Public Health Research & Practice 29, e2921914
| Lessons from the renewal of the National Cervical Screening Program in Australia.Crossref | GoogleScholarGoogle Scholar |
Western NSW Primary Health Network (2019) Health profile 2019. (Western NSW Primary Health Network: Orange, NSW, Australia). Available at https://www.wnswphn.org.au/uploads/documents/corporate%20documents/WNSW%20PHN%20Health%20Profile%202019%20updated.pdf [Verified 16 November 2022]
Yap D, Liang X, Garland SM, et al. (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 |