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Regional variation in cervical cancer screening participation & outcomes among Aboriginal and non-Aboriginal Australian women: New South Wales (2006-2013)

Final report July 2018
Indigenous health Indigenous women Cancer screening Cervical cancer New South Wales

Since the Australian National Cervical Screening Program (NCSP) was implemented in 1991, cervical cancer incidence and mortality rates in Australia have halved. However, Aboriginal and Torres Strait Islander women, respectfully referred to as Aboriginal women throughout this report, continue to experience a higher burden of cervical cancer than non-Aboriginal women. Since its inception, the NCSP has been unable to report on standard program performance indicators for Aboriginal women as Aboriginal status is not routinely collected by Pap Test Registers (PTRs). The NHMRC-funded “National Indigenous Cervical Screening Project” (NICSP) used probabilistic record linkage methods to combine population-based administrative health databases to identify women in the PTR who are Aboriginal.

This report describes geographical patterns in screening participation rates, prevalence of high-grade cervical abnormalities and rates of clinical investigation within two-months after an abnormal Pap test for Aboriginal and non-Aboriginal women across 153 Local Government Areas (LGAs) in New South Wales (NSW). Additional estimates for 11 larger Primary Health Networks (PHN) and 16 Local Health Districts (LHD) are also presented.

Key Findings:

  • It was found that cervical screening participation rates and prevalence of high-grade cervical abnormalities varied substantially between different LGAs in New South Wales from 2006 to 2013, with some suggestion of geographical variation in the timely follow-up of abnormal Pap smear results.
  • Aboriginal women had consistently lower cervical screening participation rates and poorer related outcomes across all geographical areas in NSW.
  • Increasing overall participation rates in cervical screening for Aboriginal women may enable earlier detection and subsequent treatment of precancerous cervical abnormalities before any possible progression to cervical cancer.
  • Aboriginal women also have higher smoking rates, lower age at first full term pregnancy and higher fertility rates and are more likely to reside in socio-economically disadvantaged areas, (16) all of which are risk factors for high-grade cervical abnormalities.

Overall, these results suggest there are opportunities to improve screening participation and outcomes among Aboriginal women in many geographical areas. This report is the first to present small-area maps of cervical screening participation rates and related outcome measures in NSW by Aboriginal status. It provides a valuable resource for those administering cervical screening programs to identify areas of disparity and motivate investigations to uncover why these patterns exist.


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