Robyn Mullins
Jenny Anderson
CBRC Research Paper Series No. 33
Cervical cancer is a potentially fatal disease which is associated with the human papilloma virus (HPV). Until recently, the prevention of cervical cancer depended on the use of the Pap test to detect abnormal changes in the cells of the cervix early enough to allow them to be treated appropriately. The development of an HPV vaccine has now provided an additional way of reducing the incidence of cervical cancer. The recommendation in Australia is still that women have a Pap test every two years, regardless of whether they have been vaccinated against HPV.
This paper reports on findings from the cervical screening component of a large telephone survey conducted by CBRC in 2007 which included 1129 women. Women were asked a series of questions about their Pap test behaviour, the risk factors for cervical cancer and knowledge of the HPV vaccine.
Ninety per cent of the women surveyed had had at least one Pap test, and of those 83% said it had been within the last 2 years. About one-quarter of women indicated their doctor had suggested their last Pap test, whereas the others had initiated their own test, either unprompted (36%) or after receiving a reminder letter (37%). Two-thirds of women saw their usual doctor for their Pap test.
Women's knowledge of any factors which can contribute to the risk of cervical cancer was poor, with 46% unable to name any factor and only one in ten mentioning HPV. Awareness of the vaccine was very high (94%), as was awareness that Pap tests were still needed even after vaccination (90% of those who knew of the vaccine). However, they were unsure or incorrect about many of the specific features of the vaccine: only half knew that the vaccine was not effective at preventing cancer in women of any age group; just over half knew the vaccine would not prevent all cervical cancers if given early enough and two-thirds knew the vaccine could not be used as a treatment. Reassuringly, only 5% of women overall said the availability of the vaccine would make them less likely to have a Pap test in future, but this applied to one in ten of the women in the age group 18-26, who are most likely to be vaccinated.
Women's stated awareness that Pap tests are still needed after vaccination is encouraging, however, they do not appear to have a good understanding of the link between HPV and cervical cancer or how the vaccination reduces the risk of cervical cancer. PapScreen needs to continue to educate women so that they understand why they still need to have Pap tests.