Human Papillomavirus (HPV) Self-Sampling among Never-and Under-Screened Indigenous Māori, Pacific and Asian Women in Aotearoa New Zealand: A Feasibility Study

Collette Bromhead, Helen Wihongi, Susan M. Sherman, Sue Crengle, Jane Grant, Georgina Martin, Anna Maxwell, Georgina McPherson, ‘Aivi Puloka, Susan Reid, Nina Scott and Karen Bartholomew
Additional contact information
Collette Bromhead: School of Health Sciences, Massey University, Wellington 6021, New Zealand
Helen Wihongi: Ngāti Porou, Ngāpuhi, Te Whānau a Apanui, Ngāti Hine, Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
Susan M. Sherman: School of Psychology, Keele University, Keele ST5 5BG, UK
Sue Crengle: Waitaha, Kāti Mamoe and Kāi Tahu, Department of Preventive and Social Medicine, University of Otago, Dunedin 9016, New Zealand
Jane Grant: Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
Georgina Martin: Te Rarawa, Te Aupōuri, Ngāpuhi, Wai Research, Te Whānau O Waipareira. Level 1, 6-8 Pioneer Street, Henderson, Waitakere City, Auckland 0605, New Zealand
Anna Maxwell: Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand
Georgina McPherson: Makea Ngāti Kao, Ngāti Tane, Waitematā District Health Board, Auckland 0740, New Zealand
‘Aivi Puloka: The Fono Health & Social Services, Henderson, Auckland 0612, New Zealand
Susan Reid: Te Rarawa, Health Literacy New Zealand Limited, Auckland 1347, New Zealand
Nina Scott: Ngāpuhi, Ngāti Whātua, Waikato, Waikato District Health Board, Hamilton 3240, New Zealand
Karen Bartholomew: Waitematā District Health Board and Auckland DHB, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand

IJERPH, 2021, vol. 18, issue 19, 1-15

Abstract: In Aotearoa, New Zealand, the majority of cervical cancer cases occur in women who have never been screened or are under-screened. Wāhine Māori, Pacific and Asian women have the lowest rate of cervical screening. Self-sampling for human papillomavirus (HPV-SS) has been shown to increase participation in cervical cancer screening. A whole-of-system approach, driven by evidence in the most effective delivery of HPV-SS, is required to mitigate further widening of the avoidable gap in cervical screening access and outcomes between groups of women in Aotearoa. This single-arm feasibility and acceptability study of HPV self-sampling invited never- and under-screened (≥5 years overdue) 30–69-year-old women from general practices in Auckland, Aotearoa. Eligible women were identified by data matching between the National Cervical Programme (NCSP) Register and practice data. Focus groups were additionally held with eligible wāhine Māori, Asian and Pacific women to co-design new patient information materials. Questionnaires on HPV knowledge and post-test experience were offered to women. Our follow-up protocols included shared decision-making principles, and we committed to follow-up ≥90% of women who tested positive for HPV. Data matching identified 366 eligible never- and under-screened wāhine Māori, Pacific and Asian women in participating practices. We were only able to contact 114 women, and 17, during the discussion, were found to be ineligible. Identifying and contacting women overdue for a cervical screen was resource-intensive, with a high rate of un-contactability despite multiple attempts. We found the best uptake of self-sampling was at focus groups. Of the total 84 HPV-SS tests, there were five positive results (6%), including one participant with HPV18 who was found to have a cervical Adenocarcinoma at colposcopy. In our feasibility study, self-sampling was acceptable and effective at detecting HPV and preventing cervical cancer in under-screened urban wāhine Māori, Pacific and Asian women in Aotearoa. This is the first report of cervical Adenocarcinoma (Grade 1B) as a result of an HPV-18 positive self-sample in Aotearoa. We co-designed new patient information materials taking a health literacy and ethnicity-specific approach. This work provides policy-relevant information to the NCSP on the resources required to implement an effective HPV self-sampling programme to improve equity in national cervical cancer screening.

Keywords: indigenous health research; equity; cervical cancer screening; HPV; self-sampling; Kaupapa Māori Research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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