Attitudes to changes in cervical screening guidelines: Preliminary views of Australian general practitioners and nurse practitioners

Background: Since its inception in 1991, the organised Australian National cervical cytology screening programme has resulted in the reduction in incidence and mortality from cervical cancer. However,under the Renewal program, these guidelines will change from May 1st 2017, from cytology screening biennially from 18 years, to HPV DNA testing every 5 years from 25 years of age for those repeat negative.
Objectives: To establish the attitudes of Australian general practitioners (GPs) and nurse practitioners to renewed cervical screening guidelines, specifically to delaying onset of screening from 25 years, widening the screening interval to 5 years and adopting an HPV DNA test as a primary screening method.
Study design: GPs and nurse practitioners were invited to complete an online survey through advertisements in e-newsletters. The survey assessed participants’ demographics, cervical screening practices and perceived barriers to screening according to the proposed new guidelines. Responses were on a 7-point Likert scale. Statistical analysis was performed using the chi-square for categorical variables and student T-test for continuous variables. Adjusted odds ratios were determined using multivariate logistic regression.
Results: Of the 191 respondents, 50% were GPs. Mean age was 48 years, 90% were female, 81% had graduated from Australian or New Zealand-based universities, and 64% practiced in metropolitan areas. The majority of both professional groups (84% GPs, 75%nurse practitioners) were willing to accept the proposed renewed guidelines. However, approximately half of respondents were concerned that young women would not attend for other health checks, if routine pre-cancer screening were not offered (51% GPs,49% Pap nurses).
Conclusions: Whilst most participants were willing to follow the renewed guidelines, many had concerns that women would not attend for regular health checks if pre-cancer screening were not offered. A larger representative study should be undertaken to guide targeted education prior to introduction of the guidelines.