Implementation of Australia’s renewed cervical screening program: Preparedness of general practitioners and nurses

Since its establishment in 1991, the National Cervical Screening Program (NCSP) in Australia has reduced cervical cancer incidence and mortality by half. However, emerging evidence on the efficacy of primary HPV screening as well as the high coverage with HPV vaccination in Australia has prompted a restructuring of the program. The program changed from a 2-yearly pap testing for women aged 18-69 to a 5-yearly HPV testing for women aged 25-74 years including different management for oncogenic HPV type 16/type 18 positive versus HPV non type 16/type 18 positive test results. The option of self-collection for under-screened women has also been included in the renewed program. This study conducted a survey with cervical screening providers in primary care to compare levels of preparedness in administering cervical screening before and after the new program was implemented. Compared to the pre-renewal period, a higher portion of practitioners in the post-renewal period were more comfortable offering screening to women ≥25 years and more confident explaining the rationale for not screening before 25 years. Furthermore, practitioners had increased confidence in explaining a positive HPV 16/18 and positive HPV non 16/18 test results, as well as not referring women with a positive HPV non 16/18 result and negative cytology for colposcopy. A higher number of Victorian practitioners in the post-renewal period were also more comfortable and confident in recommending self-collection to under-screened women. Due to the program’s renewal, a larger proportion of practitioners had greater access to education, information and communication materials around the program changes, which resulted in practitioners who were better prepared to implement the renewed screening program.

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