The pap test registry—An important initiative for women's health

Abstract

This desire for a more organised approach to cervical cancer screening is not new. For several years health professionals active in the area of women's health have pointed out that Australia's opportunistic attitude towards cervical screening is problematic. Health professionals have argued that reliance on women to ask their doctors for a Pap test is inadequate because it assumes all women know what a Pap test is and why it is necessary. Statistics however indicate that not all women are aware of the importance of regular Pap testing. Each year in Australia 350 Australian women die from cervical cancer and a further 1000 women are treated for invasive cervical cancer. Overseas studies certainly attest to the effectiveness of organised cervical screening programs. In Iceland alone the implementation of a screening program that includes a Pap test recall and follow up system has resulted in a cervical cancer prevention rate of approximately 70% over a 20 year period. 2 A figure that stands in stark contrast to Australia's estimated prevention rate of 40%. In light of this knowledge then the Victorian Government recently agreed to establish an infrastructure through which a more organised approach to cervical cancer screening could be implemented. The Victorian Cervical Cytology Registry, more commonly known as the Pap Test Registry, was established under an amendment to the Cancer (Central Registers) Act and became operational in November 1989. Located at Prince Henry's Hospital in Melbourne it now functions as a central database for the collection and collation of Pap test results taken in Victoria. This advantages women in two important ways. Firstly it enables the Registry to send reminder letters to any women whose next Pap test is overdue. Secondly it allows the Registry to act as a safety net ensuring that all registered abnormal results are carefully followed up. Additional benefits of the Register include access to important data for epidemiological studies of cervical cancer and screening. Improved accuracy in Pap test reporting through allowing pathologists access to women's Pap test histories. Evaluation on the effectiveness of cervical education campaigns and the ability to feedback information to participating laboratories, useful in the Registry is voluntary. Women can either choose to register and so take advantage of the Registry's Pap test recall and follow up service or they can choose not to. So far 95% of Pap tests currently being taken in Victoria are recorded with the Registry, an indication that women are wholly supportive of the service.