HPV vaccination resistance and barriers in testing still prevalent for cervical cancer

Otago University Associate Professor Dr Peter Sykes says work is being done to encourage the wider availability of clinics for cervical screening.

Despite free cervical screening and self-tests, there are still barriers to women accessing appointments to prevent cervical cancer.

Otago University Associate Professor Dr Peter Sykes, who will speak at a public event in Whanganui this week, said there had been a drop in overall cervical cancer screenings, particularly in young people.

For some women, this could be due to opposition about the invasiveness of having to do a follow-up smear test or further cervical examinations such as colposcopy appointments.

Cervical cancer screening starts at age 25, and Sykes said often people make less frequent appointments with their GP at this age.

“Most people have left home and are running around being busy.”

Covid also resulted in delays to all health screenings over the past three years.

In September, the government announced a policy to fully fund free cervical screening and self-tests at a cost of $20 million a year.

About 10 per cent of people struggle to attend a colposcopy appointment, which is a further detailed cervical examination.

“I’m really trying to encourage the availability of these clinics in marae, and there’s been some work with colposcopy on [health] buses; those are things we can do to reduce those barriers.

“There’ll always be people who find attending for investigations difficult.”

Different cultures found vaginal examinations more or less challenging, and victims of sexual abuse could find it harder to attend appointments, Sykes said.

“It doesn’t take much in terms of people feeling they’re being prejudiced against, either by the system or because of the system to put people off.

“I think certainly a smear test can be uncomfortable, and if somebody has a bad experience, then they’re unlikely to return.”

The latest unpublished data comparing the cervical screening and HPV (human papillomavirus) vaccination programmes showed there was a 70 per cent reduction in the risk of cervical cancer for vaccinated people.

Only 66 per cent of New Zealand’s population is vaccinated for HPV; the World Health Organisation recommends a 90 per cent vaccination rate for HPV.

“It’s a fantastic tool, but we as a country are not utilising it to its maximum effectiveness - our vaccination rates are lower than would be ideal,” Sykes said.

There needed to be better communication of the benefits of vaccination.

“When you’ve got a strong kickback due to misinformation, sometimes making more noise makes it louder, so that’s difficult to navigate, but I think we could have been a lot clearer about the vaccination.”

There have been concerns expressed by parents of children aged 11 or 12 in getting the vaccine due to fears of complications such as Guillain-Barre syndrome. But Sykes said the syndrome was very rare and unpredictable, and there was no evidence it occurrs more frequently post-vaccination.

There had also been resistance to HPV vaccinations due to parents arguing it was unlikely their child would be sexually active around this age.

However, Sykes said there was minimal benefit in getting the vaccine after the age of 18, and a large portion of the population was sexually active at a younger age.

“If you can reduce the risk of your daughter getting cervical cancer by 70 per cent through a simple jab, that’s pretty strong, isn’t it?”

Sykes will give a Porritt Lecture on significant changes in cervical cancer screening at the Whanganui War Memorial Centre at 5.15pm on Thursday, November 16.

Eva de Jong is a reporter for the Whanganui Chronicle covering health stories and general news. She began as a reporter in 2023.