$1.4m to extend research on self-administered cervical screening in Northland

Mahitahi Hauora chief executive Phillip Balmer said self-administered cervical screening was a step towards creating an equitable healthcare system. Photo / Michael Cunningham

A $1.4m grant to continue cervical screening research means 6000 extra wāhine in Te Tai Tokerau will receive "gold-standard" HPV testing which enables women to screen themselves.

It follows a recently published study by Victoria University's Centre for Women's Health Research, which looked at whether Māori women who had not been screened regularly would do a new self-test looking for the cancer-causing Human Papilloma Virus (HPV).

The study, which involved 1539 Northland women, found almost 60 per cent of the 500 Māori women offered the self-test took it - about three times more women than those offered the standard cervical smear.

Professor Bev Lawton, director of the Centre for Women's Health Research and co-lead of the study, said HPV screening is more effective at preventing cervical cancer than the current smear test, and the new technology enables women to screen themselves.

"It's the way of the future with this science. We now know that doing a test yourself is just as good as having a doctor do it. And it is using this superior test - now we've got this gold-standard."

Now, a $1.4m Health Research Council grant has allowed the research to continue in Northland, which means an additional 6000 women will have access to the self-administered test.

Mahitahi Hauora chief executive Phillip Balmer said the purpose of the extension was to see if it could be rolled out as a national cervical screening programme.

Balmer said Mahitahi Hauora's vision was a sustainable healthcare system that achieves equitable self-determined wellbeing, and this test is a step in that direction.

"For parts of our community there have been stubborn numbers for Māori for too long. We need to be very deliberate in not shrugging our shoulders and saying 'healthcare is here, why don't they come see us'. We know there are barriers so let's make sure we're creative in how we address those," he said.

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In the three years ending December 2020, 62.1 per cent of Māori women aged 25 to 69 were screened in Northland; compared with 76 per cent of women classed as European/other.

Overall, 70.7 per cent of the eligible population was screened in Northland.

The Victoria University study found the most frequently cited barrier to current screening was whakamā — embarrassment, shyness, and/or reticence. A lack of time and fear of discomfort or pain were also leading barriers.

Kristy Wolff, Northland DHB senior medical officer, obstetrics & gynaecology, said the DHB and Mahitahi Hauora had tried numerous strategies to improve uptake of cervical screening for Māori.

"Self-screening is showing promise, and we are open to its consideration and implementation once we can confirm that the National Screening Programme can support, accommodate, and fund it."

National Cervical Screening Programme (NCSP) manager Nicki Martin said thanks to screening services and the more recent introduction of the HPV vaccine, the number of women who die from cervical cancer has dropped by two-thirds.

"While one woman dying from this preventable illness is too many, the programme continues to be a safe and effective cancer prevention initiative for the targeted age group of women 25 to 69," she said.

Martin said during the nationwide lockdown last year, routine screening was paused and resumed in June 2020 following the move to alert level 3.

She said screening providers had worked very hard to address backlogs in routine three-yearly screening, which accumulated during the lockdown, and to make women feel confident about returning to medical centres and providers for screening tests.

"The ministry is concerned that Māori and Pacific women, who already have lower rates in screening, have not re-engaged with screening services at the same levels as pre-Covid."

Martin said to address this equity gap, the NCSP was extending a social marketing campaign to encourage women to screen, and providing additional funding for free screens directed towards wāhine Māori and Pacific.

"The ministry agrees that the introduction of HPV primary screening, which includes self-testing, will strengthen the effectiveness of NCSP and promote equity outcomes, particularly removing barriers for Māori and Pacific women."

However, the change requires the development of a new fit-for-purpose ICT system which requires government funding, she said.

Meanwhile, Lawton said the current cervical screening programme was not reaching Māori women so it needed to change. The self-test programme was meant to be introduced this year but funding for it was pushed back.

Lawton urged Health Minister Andrew Little to "please push the button" on funding.

"There's a lot of people pushing for this so please push the button, for the women of Aotearoa - we need this new test."