Desiree Yap1, Xinyu Liang2, Suzanne M Garland3, Stefanie Hartley4, Alexandra Gorelik5, Gina Ogilvie6, Jeffrey Tan7, C David H Wrede7, Yasmin Jayasinghe8. 1. Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: Desiree.Yap@thewomens.org.au. 2. Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria, Australia. 3. Women's Centre for Infectious Disease, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia; Murdoch Childrens Research Institute Parkville, Victoria, Australia. 4. Women's Centre for Infectious Disease, Royal Women's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute Parkville, Victoria, Australia. 5. Melbourne EpiCentre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia. 6. Clinical Prevention Services, BC Centre for Disease, University of British Columbia, Vancouver, Canada. 7. Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia. 8. Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Australian guidelines for cervical cancer screening are being revised under the "renewal program". Physicians' willingness to accept these changes will play a pivotal role in its success. OBJECTIVE: To understand the willingness and acceptance of, as well as barriers and facilitators for Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) affiliates to screening using human papillomavirus (HPV) testing, starting at 25 years of age, every 5 years. STUDY DESIGN: An electronic survey of RANZCOG affiliates was undertaken April-June 2014, while renew was announced April 28th 2014. Responses used a 7 point Likert scale, which was dichotomized as ≤4, indicating 'unwilling' and >4, indicating 'willing' to adopt revised practices. RESULTS: Response rate was 22% (n=956): 60% were obstetricians and gynaecologists (OG); 27% general practitioner diplomates; 13% OG trainees. Overall, 60% (n=526/874) were willing to revise their screening practice. This correlated with awareness of new guidelines (p=<0.001). Fifty percent (n=438/869) of respondents were concerned about delaying to 25 years, and 48% (n=421/869) concerned cervical cancers would be missed. Reasons respondents gave for wishing to continue screening from 18 years contrary to guidelines included: women not being vaccinated (65.6%), immunosuppressed women (92.2%) and women who had been victims of childhood sexual assault (73.9%). CONCLUSIONS: The majority of RANZCOG affiliates were willing to change screening practice however, a number of barriers to delaying onset of screening age to age 25 years were reported. Effective change management strategies will need to be implemented to address the concerns raised to ensure best practice for cervical screening.
BACKGROUND: Australian guidelines for cervical cancer screening are being revised under the "renewal program". Physicians' willingness to accept these changes will play a pivotal role in its success. OBJECTIVE: To understand the willingness and acceptance of, as well as barriers and facilitators for Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) affiliates to screening using human papillomavirus (HPV) testing, starting at 25 years of age, every 5 years. STUDY DESIGN: An electronic survey of RANZCOG affiliates was undertaken April-June 2014, while renew was announced April 28th 2014. Responses used a 7 point Likert scale, which was dichotomized as ≤4, indicating 'unwilling' and >4, indicating 'willing' to adopt revised practices. RESULTS: Response rate was 22% (n=956): 60% were obstetricians and gynaecologists (OG); 27% general practitioner diplomates; 13% OG trainees. Overall, 60% (n=526/874) were willing to revise their screening practice. This correlated with awareness of new guidelines (p=<0.001). Fifty percent (n=438/869) of respondents were concerned about delaying to 25 years, and 48% (n=421/869) concerned cervical cancers would be missed. Reasons respondents gave for wishing to continue screening from 18 years contrary to guidelines included: women not being vaccinated (65.6%), immunosuppressed women (92.2%) and women who had been victims of childhood sexual assault (73.9%). CONCLUSIONS: The majority of RANZCOG affiliates were willing to change screening practice however, a number of barriers to delaying onset of screening age to age 25 years were reported. Effective change management strategies will need to be implemented to address the concerns raised to ensure best practice for cervical screening.
Authors: Suzanne M Garland; Wayne Dimech; Peter Collignon; Louise Cooley; Graeme R Nimmo; David W Smith; Rob Baird; William Rawlinson; Anna-Maria Costa; Geoff Higgins Journal: J Pathol Clin Res Date: 2018-09-11