Toolkit for engaging Under-screened and Never-screened women in the National Cervical Screening Program

Aboriginal and Torres Strait Islander women

Page last updated: 17 November 2019 (this page is generated automatically and reflects updates to other content within the website)

Barriers to screening
Engagement strategies
Healthcare provider resources
Recording information on Aboriginal and Torres Strait Islander status
Healthcare provider training
Consumer resources

Aboriginal and Torres Strait Islander women are more likely to develop invasive cervical cancer and are more likely to die from cervical cancer than non-Aboriginal and Torres Strait Islander women.

Although there is limited data on the cervical screening participation of Aboriginal and Torres Strait Islander women, studies suggest overall participation in cervical screening is 18% lower for Indigenous women than for non-Indigenous women. It is likely that the higher incidence and mortality from cervical cancer amongst Aboriginal women is linked to under-screening and late detection of pre-cancerous lesions and infection with HPV.

Barriers to screening

In addition to the general barriers women may face in participating in cervical screening, the following barriers have been identified as common for Aboriginal and Torres Strait Islander women.

Barriers for Aboriginal and Torres Strait Islander Women
  • Shame, fear and embarrassment about cervical screening and cancer
  • Distrust of healthcare providers, mainstream providers and government services
  • Lack of culturally sensitive and appropriate health services
  • Lack of Indigenous and female healthcare providers
  • Negative cultural perceptions about cancer – for example fatalistic and superstitious attitudes. This may leave some to perceive cervical screening as unnecessary
  • Lack of access to health services due to distance/remoteness and transport
  • Low knowledge/awareness of the importance and benefits of cancer screening
  • Women’s prioritisation of family needs before their own health
  • Lack of Indigenous-specific, culturally relevant educational resources e.g speaking posters, as very few local Central Australian langauges are written or read.
  • History of sexual assault
  • Language and literacy barriers

Engagement strategies

The following strategies have been shown to be effective in engaging Aboriginal and Torres Strait Islander Women in cervical screening.

Strategy

Details

Cultural safety training

Cultural safety training for healthcare providers and practice staff will help to build an understanding of culturally-based attitudes towards disease, the importance of culture and tradition and women’s business.

Culturally safe environment

Ensure that your health service is culturally safe – including culturally appropriate, easy to understand resources and Indigenous art.
Employ Indigenous staff, especially females, as doctors, health workers, nurses, receptionists or liaison officers.

Service flexibility

Offer mobile screening services to Aboriginal communities, flexible appointments, group transportation and/or transportation assistance.
Offer opportunistic screening where possible.

Choice of provider

Provide opportunities for women to choose between male/female, doctor/nurse, Indigenous/non-Indigenous cervical screening providers.
If necessary, healthcare providers should refer patients to a health services which may be more acceptable to perform cervical screening (for example, an Aboriginal medical service).

Appropriate communication

Healthcare providers should communicate in clear and respectful language. Disseminate information in the Indigenous community about services offered.


Healthcare provider resources

Recording information on Aboriginal and Torres Strait Islander status

Health services should work toward identifying and recording the Aboriginal and Torres Strait Islander status of all patients.

Collecting data on the cervical screening participation of Aboriginal and Torres Strait Islander women will enable a greater understanding of their screening behaviour and inform targeted strategies to increase their participation in screening at a local, state and national level.

Healthcare provider training

Cultural safety, cultural awareness and cultural competency training is available for healthcare providers working with Aboriginal and Torres Strait Islander communities.

National options include: Visit Australian Indigenous HealthInfoNet for a listing of additional courses available nationally and in each state/territory.

Training tool

Consumer resources