Measuring cervical screening participation to support equitable cervical cancer elimination for Aboriginal and Torres Strait Islander Peoples — The Association Specialists
  1. Schedule
  2. Oral Presentations - Innovations in health data collection and measurement for equity and action
  3. Measuring cervical screening participation to support equitable cervical cancer elimination for Aboriginal and Torres Strait Islander Peoples

Measuring cervical screening participation to support equitable cervical cancer elimination for Aboriginal and Torres Strait Islander Peoples (24207)

Louise Mitchell 1 , Tamara Butler 1 , Kate Wilkinson 1 , Julia Brotherton 2 , Joan Cunningham 3 , Sonya Egert 4 , Kristine Falzon 5 , Gail Garvey 6 , Rebecca Guy 7 , Bev Lawton 8 , Hamish McManus 7 , Claire Nightingale 2 , Marion Saville 9 , Megan Smith 10 , Claudette "Sissy" Tyson 11 , Natalie Taylor 12 , Mark Wenitong 13 , Karen Canfell 10 , Lisa J Whop 1
  1. Yardhura Walani, Australian National University, Canberra, AUSTRALIAN CAPITAL TERRITORY, Australia
  2. Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
  3. Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
  4. Inala Wangarra, Inala, QLD, Australia
  5. Waminda South Coast Women’s Health and Wellbeing Aboriginal Corporation, Nowra, NSW, Australia
  6. First Nations Cancer & Wellbeing Research Program, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
  7. Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
  8. Te Tātai Hauora o Hine – National Centre for Women's Health Research Aotearoa, Faculty of Health, Victoria University of Wellington, Wellington, Aotearoa New Zealand
  9. Australian Centre for Prevention of Cervical Cancer, Melbourne, VIC, Australia
  10. Cancer Elimination Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
  11. Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD, Australia
  12. School of Population Health, UNSW, Sydney, NSW, Australia
  13. School of Public Health, The University of Queensland, Brisbane, QLD, Australia

Background: A comprehensive campaign to reach never-screened Aboriginal and Torres Strait Islander peoples, Australia’s Indigenous peoples, is needed to achieve cervical cancer elimination by the target date of 2035. Accurate representation of screening participation is therefore critical for monitoring progress and ensuring equity, particularly service-level data derived from primary care patient management software (PMS) which underpin the National Key Performance Indicators (nKPI).

Methods: This study examines how cervical screening activity is captured within PMS used by Aboriginal Community Controlled Health Organisations participating in the Screen Your Way research program. Data audits and cleaning were undertaken, including reconciliation of PMS records with the National Cancer Screening Register (NCSR). Case studies from seven sites illustrate system-level issues and assess impacts on estimates of participation.

Results: Multiple points were identified where system design and reporting pathways may lead to systematic under-ascertainment, including limited integration between systems, poor visibility to clinical staff, and variation in recording practices. Some PMS allow viewing of NCSR data through integrated lookup functions, but data transfer into PMS records is manual and lacks standardised fields across systems. Patients with unverified NCSR history are classified as ‘not recorded’ rather than excluded from KPI calculations (representing 1567 or 42% of records at baseline). Data audits and cleaning demonstrate inconsistencies with PMS records and NCSR data, with corrections increasing service-level nKPI by 10–20%. 

Conclusion: System issues compromise service-level performance monitoring and efforts toward equitable cervical cancer elimination, with impacts across other national screening programs. Strengthening integration between PMS and the NCSR is fundamental to practice‑level continuous quality improvement. Urgent improvement is required to ensure nKPI reporting is reliable. Improving data quality through manual data processes, supported by practice improvement payments, is needed until reliable national estimates of Aboriginal and Torres Strait Islander participation can better inform policy and practice.