Reducing the unacceptably high rates of cervical cancer in women from remote Aboriginal communities is the aim of an Australian-first cervical screening program being trialed in WA's Kimberley region.
The program, developed by the University of Notre Dame Australia in collaboration with health providers and other research partners, enables specialist medical staff to travel to remote communities with the latest portable testing equipment, which can determine within 45 minutes whether a patient is carrying the cancer-causing human papillomavirus (HPV).
Previously, samples collected during a visit to a remote community had to be sent to a laboratory in Perth for analysis – a process that could take several weeks. If a woman was found to have HPV, she would then have to make an appointment to see a specialist at a major regional centre, often hundreds of kilometres away from her home.
Due to the long distances or issues such as road closures in the wet season, many of those specialist appointments would often be missed, preventing early diagnosis of cancerous cells.
Under the new program, women who test positive (high-risk patients) are able to undergo a same day assessment, with the help of portable camera equipment that enables a specialist to examine the cervix on site. The camera can also be used to beam live images via the Internet to experts in Perth if a second opinion is required.
UNDA post-doctoral researcher Dr Aime Powell said Aboriginal women were twice as likely to be diagnosed with cervical cancer and three times more likely to die from the disease, mainly due to a lack of testing.
She said cervical cancer was one of the most preventable and treatable cancers and cervical screening was the most effective way to detect precancerous cells. Those cells can then be removed before they develop into cancer. However, less than 50% of all eligible Kimberley women participate in routine screening at the recommended interval.
"Given the existing inequitable health outcomes, it was clear that an innovative approach was needed to improve women's access to participate in cervical screening." Dr Powell said.
"We are now able to take new portable technology to some of the most remote communities in the world. These advancements will go a long way to address some of the known barriers that may have previously discouraged women from screening."
The initiative is only possible through existing partnerships with the WA Country Health Service (WACHS), WA Cervical Cancer Prevention Program, King Edward Memorial Hospital for Women, Kimberley Aboriginal Medical Service, Australian Centre for the Prevention of Cervical Cancer, Australian National University, University of Queensland, and the University of Sydney.
WACHS Director of Obstetrics and Gynaecology, Dr Jared Watts, has used the new process at several remote communities and said Aboriginal women had warmly welcomed the changes, which include being able to self-collect their own sample in the privacy of a bathroom.
He said the ability to offer patients a same day test result was a significant step forward in the prevention of cervical cancer.
"Waiting for test results can cause patient's undue worry, and we would also be delayed in advising our high-risk patients to present at a major regional medical centre for further screening and assessment," Dr Watts said.
"Often, our patients must leave their children, families, and community to travel hundreds of kilometers to see a specialist doctor. The fact that we can now offer this service on the same day and in their communities will be of great benefit to our patients."
Dr Powell will conduct a detailed evaluation of the trial to determine its effectiveness and, if deemed successful, she hopes it could be rolled out nationally, or even internationally.
