Media release

Higher pap smear rate needed for Indigenous women

Despite a dramatic fall in deaths from cervical cancer in women from developed countries over the past 50 years, the disease is still the number one cause of cancer death among Aboriginal and Torres Strait Islander women in Australia, according the current issue of the Medical Journal of Australia. The risk of death from cervical cancer is 10 times higher in these women than in non-Indigenous women.

Dr Michael Coory, a Queensland Health epidemiologist, and colleagues analysed Pap smear data on women from 13 rural and remote Indigenous communities in Queensland. They found that the rate of participation in cervical screening is significantly lower for Indigenous women than for non-Indigenous women. On average, about 41% of women living in Indigenous communities have Pap smears every two years (compared with around 59% in the rest of Queensland), with testing rates for women from some communities as low as 20%.

"Besides low participation, other problems that affect cervical screening in Indigenous communities include the relatively high proportion of technically unsatisfactory smears (mostly due to inflammation), and difficulties following up women with screen-detected abnormalities", say the authors.

"The communities with the highest participation rates (over 50%) are those in which there is a strong commitment to training primary healthcare workers and to maintaining local recall systems.

Participation rates are likely to be higher if women have access to culturally appropriate services with a choice of service providers, including Aboriginal health workers.

In an accompanying Editorial, Dr Jenny Hunt (La Trobe University, VIC) and Lynore Geia (James Cook University, QLD) claim that for many Indigenous women, having access to a female provider is critical to the acceptability of women's healthcare services. Aboriginal Health Workers need better training in women's health. For those wanting to take Pap smears, issues of accreditation, legal cover and quality assurance need to be addressed.

"We strongly advocate that evaluators of cervical screening programs take into account not only participation rates, but also Aboriginal and Torres Strait Islander women's views about available health services and their understanding of screening-related issues", they said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT: Jennifer Muller (07) 323 40905 / (0412) 541 159

Jenny Hunt (0419) 223 989

Judith Tokley (AMA) (02) 6270 5472 / (0408) 824 306

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