Marrying research, clinical practice and cervical screening in Australian Aboriginal women in western New South Wales, Australia

Abstract

Research shows that Australian Aboriginal women experience a significantly higher rate of mortality from cervical cancer than non-Aboriginal women. We now understand that infection with human papillomavirus (HPV) is a necessary pre-requisite for cervical cancer. This knowledge, together with the development of prophylactic vaccines against the HPV types most commonly associated with cervical cancer (16 and 18), made it vital to gain nationally representative HPV genotyping data for Australian women, including Aboriginal and Torres Strait Islander women. A research project, the 'Women, Human papilloma virus prevalence, Indigenous, Non indigenous, Urban, Rural Study' (WHINURS) was designed to obtain the HPV status of Aboriginal and non-Aboriginal women when they presented for their routine cervical screen. Family Planning NSW (FPNSW), an organisation that had previously worked in community based projects to increase Aboriginal participation in cervical screening, provided an investigator site in western NSW with the intention to recruit 50 Aboriginal women and 100 non-Aboriginal women. The method was a consultative approach, including national and local frameworks for Aboriginal and Torres Strait Islander recruitment. The FPNSW Dubbo team devised a series of strategies to maximise recruitment when this did not progress according to plan. Strategies were developed to meet this challenge, including street walks, attendance at community forums, flexible appointments, drop-in times and assistance with travel and babysitting. As a result of the activities listed above, 43 women were recruited to WHINURS, just seven short of the target. Collaborative community-based consultation, as well as the research study itself increased the number of Aboriginal women accessing cervical screening at the family planning clinic. This was sustained a year after the conclusion of the study.