JMIR Publications

ABSTRACT

Background:

In December 2017, the Australian National Cervical Screening Program changed to encompass a five-yearly human papillomavirus (HPV) primary test, for women aged 25 to 74. Public concern to changes to screening programs has been demonstrated in other countries previously.

Objective:

To explore in depth women’s understanding and concerns about the specific changes to the Australian National Cervical Screening Program implemented in December 2017.

Methods:

An online petition (‘Change.org’) opposed to the changes received over 70,000 signatures and nearly 20,000 comments in February-March 2017. Of 19,633 comments, a random sample of 2000 comments (10%) were analysed using content analysis. Comments relating directly to the specific changes to the program were further analysed using qualitative thematic analysis.

Results:

Around one third (34.6%) of total comments related to concerns about specific changes to the program. The greatest concern was that screening intervals would be too long and that cancer may not be detected in time for successful treatment. Missing cancer in younger women was also an important concern, perceiving this age group to remain at significant risk. Overall, concern was often not expressed about the new test (the HPV test).

Conclusions:

Gaps in knowledge and understanding about the changes to the program and the rationale behind these have caused concern for women’s health. Concern about the extended screening interval indicates little understanding of the slow progression from HPV infection to cervical cancer or high rates of regression. Identification of these knowledge gaps can inform both de-intensification of other cancer screening programs and practitioners, so that they are able to address these concerns with their patients.