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Enhancing Cervical Screening Rates and Self-Collection Testing in General Practice

Cervical cancer is one of the most preventable cancers. In Australia, more than 70% of people diagnosed with cervical cancer have either never been screened or are not up to date with their cervical screening.1 

The CCQ region averaged a 60.9% participation rate in cervical screening compared to the national participation rate of a 62.4% between 2018-2021.2

The National Strategy for the Elimination of Cervical Cancer in Australia outlines key principles aimed at improving vaccination, screening and treatment to ensure that Australia becomes the first country in the world to eliminate cervical cancer by 2035.3 This strategy includes widespread HPV vaccination coverage, regular cervical screening, and early access, all of which are critical steps toward achieving elimination.  

Primary care providers play a critical role in driving cervical screening participation through their trusted relationships, clinical expertise and accessibility to engage patients in preventative care. Opportunistic discussions, continuity of care and patient-centred care position primary care providers to support participation and promote equitable access to drive improved cancer outcomes. 

This activity focuses on how to identify and engage your under-screened or never-screened patients and increase cervical cancer screening rates in your practice. 

February 2025 Consumer Campaign

On 4 February, to coincide with World Cancer Day, CCQ launched the Your Health. Your Way. campaign, developed in partnership with the Queensland Health Cancer Screening Unit. General practices are invited to download the digital media kit (.zip, 13MB) to use in local promotion.

Increase cervical screening rates from [X% to X%] by [DATE] and promote the option of self-collection among patients who are under-screened or never screened.

To achieve this goal, you can access a range of resources:

  1. HealthPathways: Explore locally tailored approaches for cervical cancer screening and management. Simply enter “Cervical Cancer Screening” in the search bar to get started.
  2. Review current best practice clinical guidelines:
  1. The Australian Centre for the Prevention of Cervical Cancer (ACPCC) offers a hub of resources for healthcare providers about the National Program, including self-collection. Don’t miss the free eLearning modules on cervical screening, HPV and self-collection.
  2. National Cancer Screening Register (NCSR): The NCSR supports cancer screening and can be integrated with most general practice software to show patient screening participation.
  3. The Department of Health and Aged Care has released several resources for patients, including resources for Aboriginal and Torres Strait Islander peoples.

Kickstart your quality improvement activity by bringing together a quality improvement team. Together, you’ll identify the key challenges and come up with innovative solutions, ensuring you all share a clear understanding of the improvement objectives and strategies.

  1. Engage with your Primary Health Coordinator from CCQ; they can offer tailored support, resources and guidance to enhance your QI efforts, wherever you are in your QI journey. Your Primary Health Coordinator can support your practice to:
    • Bring a QI team together to decide on an improvement idea
    • Plan, start and finish a QI activity
    • Facilitate QI meetings
    • Create practice-wide systems improvement
  2. Gather data and information. Review current practice data and processes for cervical cancer screening, including self-collection.
  3. Identify and discuss any common enablers and barriers to optimal cervical cancer screening. Consider using process maps, flow charts or driver diagrams to generate change ideas and improve processes.

What data might you need? You’ll need data to understand the problem and measure your outcomes. We suggest you start with:

  1. Primary Sense can provide insight, detailed reports, and targeted guidance on improving data quality, specifically in relation to cervical screening. The following reports are available within Primary Sense:
    • Cervical Screening Report: Identifies the number of patients who are due for cervical screening and the number of self-collected CSTs performed.
    • PIPQI Report – 10 Measures: Identifies the percentage of eligible patients with up-to-date cervical screening. This may provide you with a baseline measure.
    • Patients Booked in with Missing PIPQI/Accreditation Measures: Identifies patients booked in the next fortnight with missing cervical screening.
  2. National Cancer Screening Register (NCSR): the NCSR allows you to access and report patient clinical information for cervical screening programs directly from your clinical software or via the Healthcare Provider Portal. Before starting your QI, ensure the NCSR is integrated with your practice software and, if necessary, individual patient results from the NCSR are updated in your practice software.

To achieve your goal, you can consider several improvement ideas such as:

  1. Utilise the Primary Sense report “Patients Booked in with Missing PIP QI/Accreditation Measures” to identify patients booked with missing cervical screening and add a reminder into the practice software to prompt for opportunistic screening.
  2. Audit the practice cervical screening recall and reminder system by ensuring screening results are recorded correctly, inactive patients are deleted, and incorrect recalls and reminders are removed.
  3. Trial implementation of a nurse-led cervical screening clinic incorporating the option of self-collection. Tip: Leverage key dates like Women’s Health Week or Cervical Cancer Awareness Month to promote the clinic. 
  4. Run a patient education campaign to inform patients about self-collection using the Country to Coast Qld campaign resources. This could also include participating in community events.
  5. Audit any weekly child health appointments to add a reminder to opportunistically provide self-collection to mother if attending appointment with the child and is overdue for screening.

References

  1. Australian Institute of Health and Welfare (2019) Analysis of cervical cancer and abnormality outcomes in an era of cervical screening and HPV vaccination in Australia, AIHW, Australian Government, accessed 23 November 2023.
  2. Australian Institute of Health and Welfare (2024) Cancer screening programs: quarterly data, National Cervical Screening Program, AIHW, Australian Government, accessed 24 January 2025.
  3. National Strategy for the Elimination of Cervical Cancer in Australia | Australian Government Department of Health and Aged Care, accessed 23 November 2024.
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Aboriginal and Torres Strait IslandersCCQ acknowledges the Traditional Custodians of the land on which we work and live, and recognises their continuing connection to land, waters and community. We pay our respect to them and their cultures; and to Elders past, present and emerging.

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