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Journal article

There are significant and persistent disparities in rates of cervical screening and cervical cancer outcomes for Indigenous women. This indicates that Australia’s National Cervical Screening Program (NCSP) does not meet the needs of Indigenous women. These disparities in access must be addressed to ensure that the achievement of elimination targets includes Indigenous Australian women. Indigenous Australians account for 3.3% of Australia’s total population. Compared to non-Indigenous women, Indigenous women are 2.5 times more likely to be diagnosed with cervical cancer and are 3.8 times more likely to die of cervical cancer. Indigenous women participate in the NCSP at a lower rate than non-Indigenous women.

Data reported in this paper were from the 50 women in the Screening Matters study who self-reported that they had completed cervical screening within the last five years. The Primary Health Care Centres (PHCCs) included in this study are Aboriginal Community Controlled Health Services or Government-run clinics that serve a large proportion of Indigenous clients.

Six themes were identified through analysis of the yarns: screening as a means of staying strong and in control; overcoming fears, shame, and negative experiences of screening; needing to talk more openly about screening; relationship with screening provider is critical; logistical barriers to screening; and issues for women employed at PHCCs. Women described screening as: “painful”, “degrading”, “invasive”, “uncomfortable”, “embarrassing”, “daunting” and “scary”, and felt reluctant to participate in screening. They also felt anxious waiting for the screening results. For many women having children was a critical turning point in their lifelong screening behaviour. Having children broadened many women’s priorities to focus on staying healthy for their children and families.

The views and experiences of Indigenous Australian women who participate in cervical screening are reflected in the themes of: screening as a means of staying strong and in control; overcoming fears, shame, and negative experiences of screening; the need to talk more openly about screening; relationships with screening providers are critical; logistical barriers to screenings; and issues for women employed at PHCCs.

The findings of this study indicate that cervical screening should be conducted in a way that empowers Indigenous women to feel in control of their bodies, health, and health decision-making. While women acknowledged that cervical screening was an uncomfortable process, women overcame the emotional obstacles by recognising the benefits for themselves, their families, and their communities. The findings may also inform future public health campaigns and other cancer screening programs, such as breast screening and bowel screening. Ultimately, prioritising Indigenous women’s views and rights to control their health may support women to start and maintain participation in cervical screening, and ensure that Australia’s cervical cancer elimination goal includes all Australian women.

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