Supporting your patients in cervical screening
Open and timely communication about cervical screening with your patient is the best way to support them in making the decision to have a potentially life-saving Cervical Screening Test.
As part of your discussions with patients about cervical screening, it is important to help them understand:
- What cervical screening involves.
- Why screening is important.
- Why the Cervical Screening Test is relevant to them.
- What their test results mean.
You should also be aware of the main barriers to screening and how to address those barriers to assist your patients in overcoming them.
A recent report found that more than 40% of women are overdue for screening or have never had a Cervical Screening Test.[1]
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Navigating embarrassment, anxiety and discomfort as barriers to screening
Research conducted with women across all age groups and backgrounds indicated that many are embarrassed about discussing cervical screening with their doctors.
For some patients, cervical screening can also cause anxiety and/or be something they avoid due to the discomfort of the test.
These common barriers to screening can be a result of many different factors, including:
- Cultural beliefs and ways of thinking around medical procedures.
- Religious beliefs and practices.
- Previous negative experiences with medical procedures or medical outcomes.
- Sensitivities around gender identification, specifically with patients belonging to the LGBTQ+ community.
- Past history of sexual trauma or physical body trauma.
However, the research also showed that while the topic is often seen as uncomfortable, most women were keen to know more about screening and its benefits to their health.
You can help break down the barriers for those who feel hesitant about discussing or participating in cervical screening.
By approaching the topic of screening with sensitivity and discretion, your support can reduce its potential emotional and psychological impact on patients who feel uncomfortable about the Cervical Screening Test.
Information on breaking down screening barriers
From openly discussing cervical screening to explaining the test procedure in detail, there are many ways you can provide support and encouragement to your patients.
- Proactively raise the topic of screening and emphasise its success in preventing cervical cancer.
- Explain that anyone who has ever been sexually active can get HPV and could develop cervical cancer—even if they have had only one sexual partner.
- Encourage women to be open about their embarrassment or concern and to ask you as many questions as they need.
- Discuss options for making the test more comfortable, such as bringing a support person along, e.g. a friend or family member, inserting the speculum themselves, or offering a sheet to cover themselves.
- Discuss the option of self-collecting their sample.
- If you are discussing screening with a patient who identifies as LGBTQ+, ask if there is a particular pronoun or other gender-sensitive language they would like you to use to help make them feel more comfortable.
- Describe the procedure for the Cervical Screening Test so that they know what to expect.
- Suggest patients visit another clinic or health centre if they feel uncomfortable having the test performed by their regular GP or a male doctor.
Addressing concerns about results
The Cervical Screening Test detects infection with human papillomavirus (HPV).
Many patients have concerns about the implications of a HPV-positive result. You can help reduce these concerns by explaining the next steps, and answering all questions clearly and sensitively.
Information and resources on discussing results
The Cervical Screening and management pathway is based on the risk of developing cervical cancer, determined by the test results.
The Cervical Screening Test detects infection with human papillomavirus (HPV)
Partial genotyping is used to classify the type of HPV into one of two groups:
- Oncogenic HPV type 16/18; or
- Oncogenic HPV type not 16 or 18.
When HPV is detected, the pathology laboratory will conduct reflex liquid-based cytology on the same sample to determine if any cervical cell abnormalities are present. This determines the patient’s risk rating and triaging for colposcopy.
The pathology report will include the combined result as a risk category and the recommended management. There are three risk categories:
- Low risk – Return to screen in five years.
- Intermediate risk – Repeat the test in 12 months.
- Higher risk – Refer to specialist.
It is important to make it clear to your patient if she needs to repeat her test in 12 months or be referred to a specialist, it does not mean that she has cervical cancer. She may not even require further treatment to prevent cervical cancer.
You will need to clearly explain what her result means, and what the next steps will be.
View the National Cervical Program Clinical Guidelines>
As a Cervical Screening Test provider, the result of a patient’s test will be sent to you, usually within two to three weeks of the appointment.
It is important that your system ensures that every patient is informed of their result.
You will have your own system in place for informing patients of their result. You should explain whether they will need to call you to get their result, or whether you will contact them when the result arrives.
While many providers deliver low-risk test results over the phone, a follow-up appointment is highly recommended for communicating intermediate or higher risk results.
This will make it easier to discuss the results in detail with your patient, as well as allowing you to monitor how they respond to the news.
Naturally, some patients will be upset when they are told their cervical screening results show positive for HPV. The way you communicate the news plays a significant part in how your patient reacts.
- Clearly explain what the result means.
- Reassure your patient that an intermediate or higher risk result does not mean they have cervical cancer.
- Provide a detailed explanation of the next steps.
- Encourage your patient to ask questions or raise any concerns they may have.
You should also emphasise to your patients that you will provide the result, not the National Cancer Screening Register (NCSR) or the NSW Cervical Screening Program (NSW CSP).
Having a reminder system or tagging patient files will help you keep track of which patients are due for a Cervical Screening Test.
Remember, every appointment you have with a woman or patient with a cervix aged 25–74 is an opportunity to ask whether they are up to date with their cervical screening.
Looking to improve cervical screening rates in your practice?
View the Primary Care Cancer Control Quality Improvement Toolkit for an easy-to-follow roadmap to help improve cancer screening rates and cancer prevention activities in your health service.
A Cervical Screening Test looks for HPV. If HPV is found, the laboratory test will automatically look at the cervical cells from the same sample and, in very rare cases, cervical cancer will be detected.
If this is the case, your patient will need additional emotional and psychological support. As the health provider, your involvement will be of great importance.
You can refer to our patient portal including information and resources section specifically designed for patients with cervical cancer.
For additional support, you can refer your patient to Cancer Council NSW and encourage her to call the Cancer Council NSW helpline on 13 11 20.
If you cannot contact a patient to deliver her Cervical Screening Test results, you can contact the National Cancer Screening Register (NCSR) on 1800 627 701.
The NCSR may be able to advise whether your patient has updated their contact details.
Supporting patients with specific needs
Cervical screening is for all women and people with a cervix aged 25–to74 who have ever been sexually active.
If you have a patient with specific needs, we’ve outlined the options available to help ensure a comfortable screening experience.
Information and resources for supporting patients with specific needs
In Australia, Aboriginal and Torres Strait Islander women are twice as likely to develop and four times more likely to die from cervical cancer than non-Indigenous women.2
Aboriginal women may not have access to the same level of health information as other Australian women.
That is why it is essential to explain the importance of regular cervical screening as well as the effectiveness of the Cervical Screening Test in preventing cervical cancer.
To support Aboriginal women, you can:
- Take time to explain about what having a Cervical Screening Test involves.
- Be responsive and respond to any questions about cervical screening.
- Encourage your patient to bring a friend or family member to her appointment if it will make her feel more comfortable.
- Provide appropriate resources – see the National Cervical Screening Program information for Aboriginal women in English and six community languages.
Cervical screening is safe at any time during pregnancy. Routine antenatal and postnatal care should include a review of a women’s cervical screening history, and a Cervical Screening Test if the woman is due or overdue
View our comprehensive information for health professionals on cervical screening during pregnancy >
Women and people with a cervix from non-English speaking backgrounds may not have access to the same level of health information as other Australian women.
This is why it's crucial to explain the importance of regular cervical screening to women from this group, as well as the effectiveness of the Cervical Screening Test in preventing cervical cancer.
To support women from non-English speaking backgrounds, you can:
- Explain to your patient that interpreters are available to help her make the appointment and can also attend the appointment with her. Contact the Translating and Interpreting Services (TIS) to find out how to access free services for your patients.
- Be responsive and respond to any questions about cervical screening.
- Encourage your patient to bring a friend or family member to her appointment if it will make her feel more comfortable.
- For more information on cervical screening, your patients can access a range of free translated resources on the National Cervical Screening Program website.
To provide a comfortable screening experience for patients with disabilities, many clinics and doctor’s rooms are designed to assist wheelchair users and patients with other disabilities.
If your clinic or rooms are not accessible, you or your patient can contact Family Planning NSW, as all its clinics are accessible to and inclusive for women with physical disabilities.
If your patient is deaf or has hearing difficulties, you can refer them to the National Relay Service on 1800 627 701. This service will assist your patient in booking their Cervical Screening Test appointment and may also provide help during the appointment.
1. Australian Institute of Health and Welfare. Cervical Screening in Australia 2013–to14. Canberra: AIHW : s.n., 2016. Cancer Series no.97 Cat. no. CAN 95
2. Australian Institute of Health and Welfare: Cervical screening in Australia 2019. Cancer series no. 123. Cat. no. CAN 124. AIHW, Canberra 2019