Nurses promoting self-screening cervical cancer

A new project has highlighted the role of nurses in significantly reducing cervical cancer cases in Australia.

Globally, cervical cancer is the fourth most common cancer in women, resulting in over 600,000 new cases and 342,000 deaths yearly.

Australia has been at the forefront of cervical cancer prevention since establishing a screening program in 1991 and a school based vaccination program in 2007.

It's currently on track to becoming the first country worldwide to eliminate cervical cancer.

Nowadays, women can choose to self-collect their sample to screen for cervical cancer risk using a swab only slightly larger than the Covid-19 testing swab.

University of Melbourne's public health researcher Dr Claire Nightingale and her team are collaborating with Cancer Council Victoria to examine the rural nurses' view on self-screening.

"Nurses we have spoken to are largely supportive and see opportunities to engage under- and never-screened people," Nightingale said.

"Some pointed out the benefits of gaining time, and others saw themselves as portals for doctor education.

"Most agreed they could become a key player in adopting and promoting the choice of self-screening for cervical screening."

In the 90s, Australia adopted a screening program that lowered cancer rates by nearly 50 per cent within the first ten years.

"We used pap smears to screen for cervical cancer, like many other countries," Nightingale said.

By the end of 2017, Australia switched to human papillomavirus (HPV) testing.

HPV is a sexually transmitted infection that can cause various types of cancer, such as vaginal and anal.

Prior to the introduction of the HPV vaccine, it was estimated that 80 per cent of the Australian population contracts HPV at one point in their lives.

While the body usually clears the virus within two years, a persistent HPV infection accounts for almost all cases of cervical cancer.

Last year, roughly 900 women in Australia were diagnosed with cervical cancer, of which 222 died.

Nightingale said that the overwhelming majority of cervical cancers were preventable – up to 70 per cent of cases occur in women who do not routinely screen. 

"Self-screening offers a promising alternative," she said.

"It gives people a sense of autonomy and privacy without having to undress in front of clinicians.

"If we optimise the use of self-collection, we could get a lot more people to screen."

Everyone from the age of 25 to 74 can be screened every five years to check for the HPV virus, and can choose to collect their own vaginal sample, or have the clinician collect a cervical sample. 

Approximately 70 per cent of female Australians are up-to-date with their cervical checks.

Nightingale said that nurses help create awareness and ensure patients and doctors are comfortable with offering a choice of self-collection.

She highlighted that the nurses' specific skill sets played a crucial role in reducing the incidence of cervical cancer worldwide.

"Nurses often have connections with the community and have skills to work with under-served and vulnerable groups," she said.

"They provide equity in service delivery and promote education for both doctors and patients.

"It's essential they continue their contribution so we can eliminate cervical cancer as a public health issue in the future."

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