Reducing inequities by raising awareness and increasing access to screening for priority populations
In 2020/21 we:
- Targeted diverse communities across NSW to provide information and support about screening options including CALD, Aboriginal and Torres Strait Islander and LGBTQTI+
- Facilitated 79 community screening activations in both large scale and targeted settings such as yarning circles, retirement villages, workplaces and hospitals
- Raised awareness of the importance of screening to at least 45,000 people through our targeted community-led engagement, events and associated media coverage
- Directly informed changes to the National Cervical Screening Program, giving women eligible for screening the option to collect their own screening sample
Targeted screening awareness for Chinese and Korean speaking women in Western Sydney
NSW is the most diverse state in Australia, with 290 different languages spoken and 25% of the population speaking a language other than English at home. Greater Western Sydney (GWS) is one of NSW’s most culturally and linguistically diverse regions.
In October 2020, Cancer Council NSW partnered with Cancer Institute NSW to deliver a screening program targeted at Chinese and Korean speaking women in GWS, to help raise screening rates in the region.
Key barriers to screening participation were identified as:
- The belief that screening is unnecessary without symptoms
- Fear, modesty, or embarrassment around the screening process
- Lack of knowledge of the availability, purpose, importance and benefits of screening
To help combat these barriers, Cancer Council NSW and Cancer Institute NSW held six in-language workshops, to improve awareness and knowledge of breast and cervical screening programs.
Volunteers and members of the community were trained to deliver and champion this work to further extend the reach. Following completion of the workshops, participants had a notably higher level of knowledge of screening services and how to access them in NSW. Over 60% of participants also indicated that they intended to book their next screening test after the workshop.
Breaking down barriers to reduce inequity in cervical screening
In 2020, the World Health Organization (WHO) launched a global strategy to eliminate cervical cancer as a public health problem. Australia has been at the forefront of cervical cancer prevention and control for decades and is on track to be the first country in the world to eliminate cervical cancer, by 2028.
While Australia has one of the lowest rates of cervical cancer in the world, a study led by Cancer Council NSW and the Australian National University found that, despite having access to screening and vaccinations programs, Aboriginal and Torres Strait Islander women experience cervical cancer at the same rate as those in developing countries.
There are numerous barriers to screening for these women including:
- Limited access to health care – physical and financial barriers, or limited access to care that is culturally safe and appropriate
- Issues relating to health care providers, such as limited female practitioners or previous negative experiences
- Beliefs around cancer, including stigma
- Low awareness about HPV vaccination and cervical screening, or a lack of culturally appropriate information
- Impacts of colonisation
A study released earlier this year, led by Associate Professor Megan Smith, Associate Professor at the Daffodil Centre, found that broadening the eligibility for self-collection to all eligible people would be an effective approach to further reduce cervical cancer incidence in Australia by helping to reach more women who are not currently participating in screening.
As a less invasive approach to the standard speculum procedure, self-collection – which a person with a cervix can do themself – could help overcome the barriers some women experience to having clinician-collected cervical screening.
This research directly informed changes to the National Cervical Screening Program, announced in November 2021, that will enable all people eligible for screening to collect their own sample if they prefer from July 2022.
Professor Karen Canfell, Director of the Daffodil Centre, said this change would be a game-changer for cervical cancer elimination.
“Australia is already on track to be the first country in the world to eliminate cervical cancer, but by making self-collection a universal option, we should get there sooner and in a more equitable way.”
Professor Canfell reminded all women who are overdue for a cervical screening test to follow up as soon as possible. “The changes from next July are a great step forward but people overdue for a screening test should not delay and are urged to talk with their doctor as they may be eligible to collect their own sample for screening now.”