AbstractSince the introduction of the Australian National Cervical Screening Program (NCSP) in 1991, cervical cancer incidence and mortality in Australia have decreased by over 50%. However, incidence and mortality for Indigenous women are two and four times higher respectively than for non-Indigenous women. The NCSP is unable to report on program performance indicators for Indigenous women because Indigenous status is not routinely collected by Pap Smear Registers (PSRs).
This thesis linked data from the Queensland PSR with hospital inpatient and cancer registry data to investigate cervical screening participation, prevalence of cervical abnormalities and time to clinical investigation following a high-grade abnormality for Indigenous compared with non-Indigenous women.
The main findings were:
1. Linking PSR to inpatient data was a feasible means to achieve reliable (but not perfect) identification of Indigenous women in cervical screening data.
2. Screening participation was considerably lower for Indigenous than non-Indigenous women in all categories of age-group, remoteness and socioeconomic disadvantage and has not improved over time. There was a large decline in participation among young Indigenous women.
3. Among screened women, Indigenous women had markedly higher prevalence of both cytology- and histology-confirmed cervical abnormalities than non-Indigenous women. The prevalence of cytology-detected high-grade abnormalities appeared to be increasing over time among Indigenous women only.
4. Indigenous women with a cytology-detected high-grade abnormality were less likely to receive clinical investigation within the recommended time frame of two months, but did eventually receive follow-up.
This thesis reports the first population-based findings for Indigenous women in Queensland, highlighting the importance of including Indigenous status in administrative datasets. These findings are timely given the announcement of the Renewed NCSP to be introduced in 2017. These results can inform policy and practice in the prevention of cervical cancer amongst Indigenous women.
Secondary Supervisor : Kamalini Lokuge
Note: Please note that some published articles in the thesis are available in hard copy only.
|Date of Award||Mar 2016|
|Supervisor||John Condon (Supervisor), Gail Garvey (Supervisor) & Peter Baade (Supervisor)|