Abstract: Aims: Cervical cancer is the second most common cancer in women and the sixth leading cause of death worldwide. The incidence of cervical cancer in Aboriginal women is more than twice that of non-Aboriginal women and their mortality rate is fourfold higher. Despite this, Aboriginal women are significantly under screened with respect to cervical cancer screening due to complex cultural and socio-economic factors. The recent discovery of HPV as the primary causative agent in most cervical cancers has opened the door to HPV testing as an alternative to the traditional Pap test as a means of detecting cervical cancer. HPV testing as a primary screening test allows for self-sampling which may overcome some of the barriers to Pap testing, including being less-obtrusive, and this may make in a more acceptable screening practice for Aboriginal women. This study is exploring the feasibility and acceptability of HPV self-sampling as a cervical screening approach for Aboriginal women using a nurse-led community engagement approach. Methods: Following a comprehensive collaboration and co-creation process, eight rural centres in Western NSW were selected. Primary Healthcare Nurses (PHCNs), are working alongside Local Aboriginal Land Council Community Engagement Workers to identify, engage with, and provide culturally appropriate education to, Aboriginal women around the value of cervical cancer screening. Women are firstly offered assistance in procuring a regular Pap test and if they refuse, consenting women are assessed for eligibility for the study via an interview. Eligible participants can then conduct the self-sampling. HPV testing is being conducted by the Victorian Cytology Service with results forwarded to the participant, their nominated GP and the PHCN. Follow-up by the PHCN includes a discussion of the results, including referral information if required, along with an Evaluation Questionnaire. Results: Within the first month of the pilot, 6 of the 8 sites have commenced the trial. Of the expected 266 sample size, a total of 11 participants have been recruited and their swabs sent for cytology. Early results suggest a general interest and acceptance of the HPV self-sampling concept within the local Aboriginal communities. Conclusions: At the completion of the pilot, we will have developed a model created with and for Aboriginal women. It is anticipated that the results of this study will contribute to the work of others who are trialling the use of self-sampling and will inform the National Cervical Screening Program (May 2017), specifically in relation to Aboriginal women.
Campbell, Laurinne, Vail, Anne, Pollard, Georgia-Lee, Bailey, Jannine, Dutton, Tegan, Robinson, Tracy, Jacob, Sunil, Wykes, Rene, O'Connor, Megan, Kelly, Cassandra, Callan, Nichole, McKay, Kate, Tiffen, Rozlyn, 2017, HPV self-sampling for cervical cancer screening: engaging under-screened rural-remote Aboriginal women, Conference Paper, viewed 17 July 2019, https://www.nintione.com.au/?p=11131.