Aboriginal and Torres Strait Islander people

Find information and resources on how to engage Aboriginal and Torres Strait Islander patients in cervical screening.

Resources

For patients

You can provide these resources to patients to help them before, during and post screening. See the full resource library.

    Before screening appointment

    During screening appointment

    Post screening appointment

    For health care providers

    You can use these resources to prepare for an appointment with an Aboriginal and Torres Strait Islander woman:

    Considerations

    Compared to non-Indigenous people, Aboriginal and Torres Strait Islander women are more likely to:

    • develop invasive cervical cancer
    • die from cervical cancer.

    We have limited data on Indigenous women’s participation in screening. Studies suggest participation in cervical screening is 18 percentage points lower for Indigenous women than for non-Indigenous women.

    It’s likely that the higher incidence and mortality from cervical cancer among Aboriginal and or Torres Strait Islander women is linked to:

    • under-screening
    • late detection of pre-cancerous lesions.

    Barriers

    There are general barriers that people face in participating in cervical screening. Aboriginal and Torres Strait Islander women face extra barriers relating to:

    • shame, fear and embarrassment about cervical screening and cancer
    • distrust of healthcare providers, mainstream providers and government services.
    • lack of culturally sensitive and appropriate health services.
    • lack of Indigenous and female healthcare providers.
    • negative cultural perceptions about cancer – for example fatalistic and superstitious attitudes
    • perceptions of cervical screening as unnecessary
    • lack of access to health services due to distance, remoteness and transport.
    • low knowledge or awareness of the importance and benefits of cancer screening.
    • women’s prioritisation of family needs before their own health
    • lack of Indigenous-specific, culturally relevant educational resources (e.g speaking posters, as very few local Central Australian languages are written or read)
    • history of sexual assault
    • language and literacy barriers.

    Ways to engage

    The strategies below are effective in engaging Aboriginal and Torres Strait Islander women in cervical screening.

    Strategy

    Details

    Cultural safety training

    Cultural safety training for healthcare providers and practice staff will help to build an understanding of culturally-based attitudes towards:

    • disease
    • the importance of culture and tradition
    • women’s business.

    Culturally safe environment

    • Ensure that your health service is culturally safe – including culturally appropriate, easy-to-understand resources and Indigenous art.
    • Employ Indigenous staff, especially females, as doctors, health workers, nurses, receptionists or liaison officers.

    Service flexibility

    • Offer mobile screening services to Aboriginal communities, flexible appointments, group transportation and/or transportation assistance.
    • Offer opportunistic screening where possible.

    Choice of provider

    • Provide opportunities for women to choose between male/female, doctor/nurse, Indigenous/non-Indigenous cervical screening providers.
    • Healthcare providers could refer patients to health services that are more acceptable to perform cervical screening (for example, an Aboriginal medical service).

    Choice of screening method

    • Offer the choice of either self-collection or clinician-collection screening options.
    • Explain the pros and cons of each option, including follow-up requirements if HPV is detected on a self-collected vaginal sample.
    • Consider offering home-based self-collection (e.g. via a telehealth consultation) where appropriate.
    • If clinician-collection is chosen some of the below points may assist.
      • Some patients may prefer to insert their own speculum and it can be helpful to offer this option.
      • Providing instructions on calming and deep breathing techniques can also help the patient to relax.
      • A prescription of vaginal oestrogen cream before the appointment can decrease pain or discomfort for post-menopausal patients.
      • Provide a mirror in case the patient wants to view their own cervix.

    Appropriate communication

    • Healthcare providers should use clear and respectful language.
    • Provide information in the Indigenous community about services offered.
    • Let the patient know that the appointment is private and confidential.
    • Patients can bring a relative or friend with them to help them feel more comfortable.
    • Patients can ask for a female nurse or doctor.
    Last updated:

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