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

Section 6 – References and further information

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

Further information
Journal articles
References - General
References - Aboriginal and Torres Strait Islander women
References - Women from CALD backgrounds
References - Women who have experienced female genital cutting
References - Women with disabilities
References - Women who identify as lesbian, bisexual or are same-sex attracted, and people who identify as transgender and have a cervix
References - Women who have experienced sexual assault
References - Women from remote areas
References - Women who experience socio-economic disadvantage
References - Women who have had the HPV vaccine

This section provides information on further reading, as well as references for the information included throughout the Toolkit. References include the published evidence behind the barriers to cervical screening and suggested engagement strategies.

Further information

Journal articles

The following journal articles have been included because they include information relevant to engaging under-screened or never-screened women in cervical screening. Although some are several years old and refer to Pap tests as the screening modality, they may still be of interest to healthcare providers.

References - General

  • Australian Government Department of Health. National Cervical Screening Program Policy. 2016. Accessed 17 May 2016, (http://www.cancerscreening.gov.au/)
  • Australian Government Medical Services Advisory Committee. National Cervical Screening Program renewal: executive summary. Report November 2013. MSAC application no.1276. Assessment report. Canberra: Australian Government Department of Health, 2014.
  • Brouwers M, De Vito C, Bahirathan L, Carol A, Carroll J, Cotterchio M, et al. Effective interventions to facilitate the uptake of breast, cervical and colorectal cancer screening: an implementation guideline. Implementation Science 2011;6(112).
  • Camilloni L, Ferroni E, Cendales B, Pezzarossi A, Furnari G, Borgia P, et al. Methods to increase participation in organised screening programs: a systematic review. BMC Public Health. 2013;13(464).
  • Cancer Council Australia. National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding. Sydney: Cancer Council Australia, 2016.
  • Chorley A, Marlow L, Forster A, Haddrell J, Waller J. Experiences of cervical screening and barriers to participation in the context of an organised programme: a systematic review and thematic synthesis. Psychooncology. 2016 [Epub ahead of print].
  • Day S, van Dort P, Tay-Teo K. Improving participation in cancer screening programs: a review of social cognitive models, factors affecting participation, and strategies to improve participation. Melbourne: Victorian Cytology Service; 2010.
  • Decker K, Turner D, Demers A, Martens P, Lambert P, Chateau D. Evaluating the effectiveness of cervical cancer screening invitation letters. Journal of Women’s Health. 2013;22(8):687-93.
  • Dieng M, Trevena L, Turner R, Wadolowski M, McCaffery K. What Australian women want and when they want it: cervical screening testing preferences, decision-making styles and information needs. Health Expectations. 2013;16(2):177-88.
  • Emery J, Trevena L, Mazza, Fallon-Ferguson J, Shaw K, Williams B et al. The role of primary and community based health professionals in early detection and follow-up in cancer care - a rapid review of best practice models. New South Wales: Sax Institute; 2012.
  • Everett T, Bryant A, Griffin M, Martin-Hirsch P, Forbes C, Jepson R. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database of Systematic Reviews. 2011;5.
  • Gravitt PE. The known unknowns of HPV natural history. The Journal of Clinical Investigation 2011;121:4593-9.
  • Kyrgiou M, Koliopoulos G, Martin-Hirsch P, et al. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet 2006;367:489-98.
  • McCaffery K, Irwig L. Australian women’s needs and preferences for information about human papillomavirus in cervical screening. Journal of Medical Screening. 2005;12:134–41.
  • Morrell S, Taylor R, Zeckendorf S, Niciak A, Wain G, Ross J. How much does a reminder letter increase cervical screening among under-screened women in NSW? Australian and New Zealand Journal of Public Health. 2005;29(1):78-84.
  • Munro A, Pavicic H, Leung Y, Westoby V, Steel N, Semmens J, et al. The role of general practitioners in the continued success of the National Cervical Screening Program. Australian Family Physician. 2014;43(5):293-6.
  • O’Connor M, Murphy J, Martin C, O’Leary J, Sharp L, Irish Cervical Screening Consortium. Motivators for women to attend cervical screening: the influential role of GPs. Family Practice. 2014;31(4):475-82.
  • Women’s Health Queensland Wide Inc., 2013, Vaginal oestrogen cream: Ask a Health Question, Accesses 19 May 2017, (http://womhealth.org.au/conditions-and-treatments/ask-health-question-vaginal-oestrogen-cream )
  • Rennie D, Boxsell J, Pedretti K. A team care model of cervical screening in a general practice. Australian Family Physician. 2015;44(7):515.
  • Sabatino S, Habarta N, Baron R, Coates R, Rimer B, Kerner J, et al. Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers: systematic reviews of provider assessment and feedback and provider incentives. American Journal of Preventive Medicine. 2008;35(1):S67-74.
  • Stewart R, Thistlethwaite J. Pap tests: What do women expect? Australian Family Physician. 2010;39(10):775.
  • Waller J, Bartoszek M, Marlow L, Wardle J. Barriers to cervical cancer screening attendance in England: a population-based survey. Journal of Medical Screening. 2009;16(4):199-204.
  • Zapka J, Lemon S. Interventions for patients, providers, and health care organizations. Cancer. 2004;101(5):1165-87.
  • Victorian Cervical Cytology Registry. Statistical Report. The Victorian Cervical Cytology Registry (VCCR), 2013, www.vccr.org/data-research/statistical-reports/annual-statistical-reports/statistical-report-2013 (accessed 2 November 2016).

References - Aboriginal and Torres Strait Islander women

  • Aboriginal and Torres Strait Islander Women’s Forum. Principles of Practice, Standards and Guidelines for Providers of Cervical Screening Services for Indigenous Women. Canberra: Australian Government Department of Health and Aging; 2004.
  • Angus S. A model for engaging and empowering Indigenous women in cancer screening. Cancer Forum. 2005:29(1).
  • Australian Government Department of Health. Principles of practice, standards and guidelines for providers of cervical screening services for indigenous women. Canberra, 2004. Accessed 17 May 2017.(http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/content/cv-indi-women-cnt)
  • Australian Institute of Health and Welfare, Cancer Australia 2013. Cancer in Aboriginal and Torres Strait Islander peoples of Australia: an overview. Cancer series No.78. Cat. no. CAN 75. Canberra: Australian Institute of Health and Welfare; 14.
  • Australian Institute of Health and Welfare 2015. Cervical screening in Australia 2012–2013. Cancer series No. 93. Cat. No. CAN 91. Canberra: Australian Institute of Health and Welfare; 27.
  • Australian Institute of Health and Welfare. Cervical screening in Australia 2013–2014. Cancer Series No. 97. Cat. No. CAN 95. Canberra: Australian Institute of Health and Welfare; 2016.
  • Binns P, Condon J. Participation in cervical screening by Indigenous women in the Northern Territory: a longitudinal study. Medical Journal of Australia. 2006;185(9):490-4.
  • Coory M, Fagan P, Muller J, Dunn N. Participation in cervical cancer screening by women in rural and remote Aboriginal and Torres Strait Islander communities in Queensland. Medical Journal of Australia. 2002;177(10):544-7.
  • Kolahdooz F, Jang S, Corriveau A, Gotay C, Johnston N, Sharma S. Knowledge, attitudes, and behaviours towards cancer screening in indigenous populations: a systematic review. The Lancet Oncology. 2014;15(11):e504-16.
  • Reath J, Carey M. Breast and cervical cancer in Indigenous women: overcoming barriers to early detection. Australian Family Physician. 2008;37(3):178.
  • Shahid S, Finn L, Bessarab D, Thompson S. Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer and its impact on access to cancer services. BMC Health Services Research. 2009;9(132).
  • Shannon G, Franco O, Powles J, Leng Y, Pashayan N. Cervical cancer in Indigenous women: The case of Australia. Maturitas. 2011;70(3):234-45.
  • Thurecht K. Aboriginal women talk about Pap smear screening for cervical cancer in South-East Queensland. Aboriginal and Islander Health Worker Journal. 2000;24(5):21.
  • Whop L, Garvey G, Baade P, Cunningham J, Lokuge K, Brotherton J, et al. The first comprehensive report on Indigenous Australian women's inequalities in cervical screening: A retrospective registry cohort study in Queensland, Australia (2000-2011). Cancer. 2016;122(10):1560-9.

References - Women from CALD backgrounds

  • Abdullahi A, Copping J, Kessel A, Luck M, Bonell C. Cervical screening: Perceptions and barriers to uptake among Somali women in Camden. Public health. 2009;123(10):680-5.
  • Adams J, Adam M. Mama & Nunu (Mother and Baby) Pregnancy Care for African Women: an Information Manual for Service Providers. Melbourne: Women’s Health West; 2001.
  • Aminisani N, Armstrong B, Canfell K. Cervical cancer screening in Middle Eastern and Asian migrants to Australia: a record linkage study. Cancer Epidemiology. 2012;36:e394–400.
  • Chang S, Woo J, Yau V, Gorzalka B, Brotto L. Cervical cancer screening and Chinese women: insights from focus groups. Frontiers in Psychology. 2013;4(48).
  • Day S, van Dort P, Tay-Teo K. Improving participation in cancer screening programs: a review of social cognitive models, factors affecting participation, and strategies to improve participation. Melbourne: Victorian Cytology Service; 2010.
  • Federation of Ethnic Councils of Australia. Cancer and culturally and linguistically diverse communities. Canberra: Federation of Ethnic Communities Councils of Australia; 2010.
  • Ilter E, Celik A, Haliloglu B, Unlugedik E, Midi A, Gunduz T, Ozekici U. Women's knowledge of Pap smear test and human papillomavirus: acceptance of HPV vaccination to themselves and their daughters in an Islamic society. International Journal of Gynecological Cancer. 2010;20(6):1058-62.
  • Kwok C, White K, Roydhouse J. Chinese-Australian women’s knowledge, facilitators and barriers related to cervical cancer screening: a qualitative study. Journal of Immigrant and Minority Health. 2011;13(6):1076-83.
  • Lesjak M, Hua M, Ward J. Cervical screening among immigrant Vietnamese women seen in general practice: current rates, predictors and potential recruitment strategies. Australian and New Zealand Journal of Public Health. 1999;23(2):168-73.
  • Lu M, Moritz S, Lorenzetti D, Sykes L, Straus S, Quan H. A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC Public Health. 2012;12(413).
  • Marlow L, Waller J, Wardle J. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. Journal of Family Planning and Reproductive Health Care. 2015. [Epub ahead of print].
  • Marlow L, Wardle J, Waller J. Understanding cervical screening non-attendance among ethnic minority women in England. British Journal of Cancer. 2015;113(5):833-9.
  • Ogunsiji O, Wilkes L, Peters K, Jackson D. Knowledge, attitudes and usage of cancer screening among West African migrant women. Journal of Clinical Nursing. 2013;22(7-8):1026-33.
  • Phillipson L, Larsen-Truong K, Jones S, Pitts L. Improving cancer outcomes among culturally and linguistically diverse communities: a rapid review. New South Wales: Cancer Institute NSW; 2012.
  • Redwood-Campbell L, Fowler N, Laryea S, Howard M, Kaczorowski J. 'Before You Teach Me, I Cannot Know': Immigrant Women's Barriers and Enablers With Regard to Cervical Cancer Screening Among Different Ethnolinguistic Groups in Canada. Canadian Journal of Public Health. 2011;102(3):230-4.
  • Saleh M, Barlow, Stewart K, Meiser B, Tucker K, Eisenbruch M, Kirk J. Knowledge, attitudes and beliefs of Arabic-Australians concerning cancer. Psycho-Oncology. 2012 Feb 1;21(2):195-202.
  • Sheikh-Mohammed M, MacIntyre C, Wood N, Leask J, Isaacs D. Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. Medical Journal of Australia. 2006;185(11-12):594-7.
  • Taylor, R., Mamoon, H., Morrell, S. and Wain, G. ‘Cervical screening in migrants to Australia’, Aust N Z J Public Health, vol. 25, no. 1, 2001, pp. 55-61.
  • Victorian Cervical Cytology Registry. Improving Cancer Screening Participation in Under-Screened, Never-Screened and Hard-to-Reach Populations: Environmental Survey Results for Participants. Victoria, Australia: 2010.

References - Women who have experienced female genital cutting

  • Abdullahi A, Copping J, Kessel A, Luck M, Bonell C. Cervical screening: Perceptions and barriers to uptake among Somali women in Camden. Public health. 2009;123(10):680-5.
  • Adams J, Adam M. Mama & Nunu (Mother and Baby) Pregnancy Care for African Women: an Information Manual for Service Providers. Melbourne: Women’s Health West; 2001.
  • Family Planning Victoria. A service coordination guide: Improving the health care of women and girls affected by female genital mutilation/cutting. Melbourne: Family Planning Victoria; 2012.
  • Federation of Ethnic Councils of Australia. Cancer and culturally and linguistically diverse communities. Canberra: Federation of Ethnic Communities Councils of Australia; 2010.
  • Homed I. Female genital mutilation/cutting: a mandatory reporting tool to support health professionals. Melbourne: Women’s Health West; 2014.
  • Simpson J, Robinson K, Creighton S, Hodes D. Female genital mutilation: the role of health professionals in prevention, assessment, and management. BMJ. 2012;344:e1361.
  • United Nations Children’s Emergency Fund. Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change. New York: UNICEF; 2013.
  • Vaughan C, White N, Keogh L, Tobin J, Ha B, Ibrahim M, et al. Listening to North Yarra Communities about female genital cutting. Melbourne, The University of Melbourne; 2014.
  • Victorian State Government 2015, Better Health Channel, Female Genital Mutilation (FGM), Accessed 29 May 2017, ( https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/female-genital-mutilation-fgm )
  • World Health Organisation. Eliminating female genital mutilation: an interagency statement UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNHCR, UNICEF, UNIFEM, WHO. Geneva: World Health Organisation; 2008.

References - Women with disabilities

  • Brown H, Plourde N, Ouellette‐Kuntz H, Vigod S, Cobigo V. Brief report: cervical cancer screening in women with intellectual and developmental disabilities who have had a pregnancy. Journal of Intellectual Disability Research. 2016;60(1):22-7.
  • Cobigo V, Ouellette‐Kuntz H, Balogh R, Leung F, Lin E, Lunsky Y. Are cervical and breast cancer screening programmes equitable? The case of women with intellectual and developmental disabilities. Journal of Intellectual Disability Research. 2013;57(5):478-88.
  • Department of Health. Victorian population health survey of people with an intellectual disability 2009. Melbourne: Victorian Government Department of Health; 2009.
  • Glover G, Christie A, Hatton C. Access to cancer screening by people with learning disabilities in England 2012/13: information from the joint health and social care assessment framework. Tizard Learning Disability Review, 2014;19(4):194-8.
  • Johnson K, Strong R, Hillier L, Pitts M. Screened out! Women with disabilities and cervical screening. Melbourne: Australian Research Centre in Sex Health and Society, La Trobe University and PapScreen Victoria; 2002.
  • Marriott A, Turner S, Ashby S, Rees D. Cancer screening for people with learning disabilities and the role of the screening liaison nurse. Tizard Learning Disability Review. 2015;20(4):239-46.
  • Marriott A, Turner S. Making reasonable adjustments to cancer screening. England: Public Health England; 2015.
  • Merten J, Pomeranz J, King J, Moorhouse M, Wynn R. Barriers to cancer screening for people with disabilities: A literature review. Disability and Health Journal. 2015;8(1):9-16.
  • Munro A, Pavicic H, Leung Y, Westoby V, Steel N, Semmens J, et al. The role of general practitioners in the continued success of the National Cervical Screening Program. Australian Family Physician. 2014;43(5):293-6.
  • NSW Cervical Screening Program. Preventative women's health-care for women with disabilities - Guidelines for General Practitioners. Sydney: NSW Cervical Screening Program; 2003.
  • Swaine J, Parish S, Luken K. Breast and cervical cancer screening for women with intellectual disabilities. Health & Social Work. 2013;38(3):183-6.
  • Thierry J. Increasing breast and cervical cancer screening among women with disabilities. Journal of Women’s Health & Gender-Based Medicine. 2000;9(1):9-12.
  • Wallace D. Accessing Screening Services: A Review of the Literature and Local Practice in the context of the Equality Delivery System. England: Public Health England; 2013.
  • Walker J, Allan H. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients? Journal of Clinical Nursing. 2014;23(13-14):1857-65.
  • Wood R, Douglas M. Cervical screening for women with learning disability: current practice and attitudes within primary care in Edinburgh. British Journal of Learning Disabilities. 2007;35(2):84-92.

References - Women who identify as lesbian, bisexual or are same-sex attracted, and people who identify as transgender and have a cervix

  • Curmi C, Peters K, Salamonson Y. Lesbians’ attitudes and practices of cervical cancer screening: a qualitative study. BMC Women's Health. 2014;14(153).
  • Douglas C, Deacon R, Mooney-Somers J. Pap smear rates among Australian community-attached lesbian and bisexual women: some good news but disparities persist. Sexual Health. 2015;12(3):249-56.
  • Fish J. Cervical screening in lesbian and bisexual women: a review of the worldwide literature using systematic methods. Leicester: NHS Cervical Screening Programme; 2009.
  • Heath M, Mulligan E. Seeking open minded doctors-how women who identify as bisexual, queer or lesbian seek quality health care. Australian Family Physician. 2007;36(6):469-71.
  • Johnson M, Nemeth L, Mueller M, Eliason M, Stuart G. Qualitative Study of Cervical Cancer Screening Among Lesbian and Bisexual Women and Transgender Men. Cancer Nursing. 2016. [Epub ahead of print].
  • Light B, Ormandy P. Lesbian, Gay and Bisexual Women in the North West : A Multi-Method Study of Cervical Screening Attitudes, Experiences and Uptake. United Kingdom: University of Salford; 2011.
  • McNair R, Szalacha L, Hughes T. Health status, health service use, and satisfaction according to sexual identity of young Australian women. Women's Health Issues. 2011;21(1):40-7.
  • Mooney-Somers J, Deacon R, Richters J, Parkhill N. Women in contact with the gay and lesbian community in Sydney: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014. Sydney: University of Sydney; 2015.
  • Smith E, Dyson S. Victorian lesbian, gay, bisexual, gender diverse and intersex people’s participation in cervical cancer screening. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2016.
  • Tracy J, Lydecker A, Ireland L. Barriers to cervical cancer screening among lesbians. Journal of Women's Health. 2010;19(2):229-37.
  • Tracy J, Schluterman N, Greenberg D. Understanding cervical cancer screening among lesbians: a national survey. BMC Public Health. 2013;13(442).

References - Women who have experienced sexual assault

  • Australian Bureau of Statistics, Personal Safety Australia, 2012, Available at http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4906.0Chapter2002012
  • Cadman L, Waller J, Ashdown-Barr L, Szarewski A. Barriers to cervical screening in women who have experienced sexual abuse: an exploratory study. Journal of Family Planning and Reproductive Health Care. 2012;38(4):214-20.
  • Carlson K. Barriers to cervical screening experienced by victims/survivors of sexual assault – a pilot study. Melbourne: Centre Against Sexual Assault; 2002.
  • Farley M, Golding J, Minkoff J. Is a history of trauma associated with a reduced likelihood of cervical cancer screening? Journal of Family Practice. 2002;51(10):827-30.
  • Mott S, Harsanyi A, Kendall S, Blight A. The impact of a history of child sexual assault on women's decisions and experiences of cervical screening. Australian Family Physician. 2003;32(9):761-2.
  • Walker J, Allan H. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients? Journal of Clinical Nursing. 2014;23(13-14):1857-65.

References - Women from remote areas

  • Australian Institute of Health and Welfare. Health in Rural and Remote Australia. Cat. No. PHE 6. Canberra: Australian Institute of Health and Welfare; 1998.
  • Australian Institute of Health and Welfare. Rural, regional and remote health - Indicators of health. Rural Health Series no. 5. Cat. No. PHE 59. Canberra: Australian Institute of Health and Welfare; 2005.
  • Australian Institute of Health and Welfare. Cervical screening in Australia 2013–2014. Cancer Series No. 97. Cat. No. CAN 95. Canberra: Australian Institute of Health and Welfare; 2016.
  • Dobson A, Byles J, Xenia D, Fitzgerald D, Hockey R, Loxton D, et al. Rural, remote and regional differences in women’s health: Findings from the Australian Longitudinal Study on Women’s Health. Newcastle: Women’s Health Australia; 2011.
  • Australian Institute of Health and Welfare 2015. Cervical screening in Australia 2012–2013. Cancer series no. 93. Cat. no. CAN 91. Canberra: Australian Institute of Health and Welfare; 27.
  • Racey C, Withrow D, Gesink D. Self-collected HPV testing improves participation in cervical cancer screening: a systematic review and meta-analysis. Canadian Journal of Public Health. 2013;104(2):e159-66.

References - Older women

References - Women who experience socio-economic disadvantage

  • Australian Bureau of Statistics. Health Literacy, Australia. Canberra: Australian Bureau of Statistics, 2008.
  • Australian Institute of Health and Welfare 2017. Cervical screening in Australia 2014–2015. Cancer series no. 105. Cat. no. CAN 104. Canberra: AIHW.

References - Women who have had the HPV vaccine