Discussing screening with patients

Cervical screening and your patients

Research conducted with women across all age groups and backgrounds indicated that many are embarrassed about discussing cervical screening with their doctors.

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.

Almost 45% of Australian women do not attend regular cervical screening[1]

As a doctor or nurse in a general practice or community health setting, you can help ‘break down the barriers’ for women who feel embarrassed about discussing cervical screening. Take the time to ask your female patients when they last screened and explain the benefits of regular screening.

Talking about cervical screening

From openly discussing cervical screening to explaining the test procedure in detail, there are many ways you can provide support and encouragement to your female patients.

  • Proactively raise the topic of screening and emphasise its success in preventing cervical cancer
  • Talk to patients about cervical cancer and the risk factors
  • Explain that HPV and/or cervical cancer is not linked to promiscuity, which is a mistaken belief held by many women – particularly those from other cultural backgrounds
  • Encourage women to be open about their embarrassment or concern, and to ask you as many questions as they need to
  • Discuss options for making the test more comfortable, such as bringing a support person along, e.g. a friend or family member, or offering a sheet to cover themselves
  • Describe the procedure for the Cervical Screening Test (the Pap test replacement*) so that they know what to expect
  • Suggest women visit another clinic or health centre if they feel uncomfortable having the test performed by their regular GP or a male doctor

Sharing screening success stories

Sharing your own examples of how cervical screening has helped avoid cervical cancer is a great way to promote this topic.

As a test provider, you can endorse the National Cervical Screening Program (NCSP) by explaining the benefits of screening and effective ways to support patients, both during their test and when delivering results.

You can also encourage your patients to share their screening stories, such as how the program helped them recognise the importance of regular screening in preventing cervical cancer.

Transitioning women to the renewed NCSP

At the establishment of the renewed NCSP (1 December 2017), women who have not had any previous abnormalities, or who have returned to routine screening after a Test of Cure, will be due for their first Cervical Screening Test two years after their last Pap test.

You may have women in your care who have had a previous screen-detected abnormality and are currently undergoing investigation, treatment or follow-up for:

  • An abnormal Pap test result
  • Histologically confirmed high-grade squamous intraepithelial lesion (HSIL) (CIN2/3)
  • Histologically confirmed adenocarcinoma in situ (AIS)

This chart shows management of women with existing abnormalities (cytology or histopathology)[2].

[1] Australian Institute of Health and Welfare. Cervical Screening in Australia 2013-14. Canberra: AIHW : s.n., 2016. Cancer Series no.97 Cat. no. CAN 95

[2] Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding, Cancer Council Australia, 2016.

*In December 2017, the cervical screening test replaced the Pap test as the method of screening women to prevent cervical cancer in Australia.