Self-testing ‘a game-changer’
Self-testing as part of cervical cancer screening will be available in two years thanks to a women’s health funding boost.
The test for human papillomavirus (HPV) can be done from home, once every five years rather than three if the test result is negative.
Health Minister Andrew Little and Associate Health Minister Dr Ayesha Verrall announced yesterday the 2021 Budget would include funding of $53 million for an easier test for human HPV, the precursor to cervical cancer.
After a five-year campaign by the medical community, underlined by Cabinet minister Kiri Allan’s diagnosis in April, this change could have 1.4 million eligible women self-testing from 2023. Allan called the change “lifesaving” and a “game changer”, on social media.
Every year about 160 people develop cervical cancer and about 50 die from it. For an increasing number of people, a smear test is not enough to detect cancer.
Women’s health doctor and senior research fellow at Victoria University Jane MacDonald said screening for the virus through a vaginal swab, rather than abnormal cells in the cervix using a speculum, was a less invasive and more effective way to test.
Vaginal swabs could be done by the patient themselves, or a medical practitioner, and only if results came back positive for HPV would a smear test be ordered. Those who initially tested negative would only need to be screened every five years instead of three. “If you are negative for high-risk HPV, your chances of developing cancer in the next five years are tiny – minuscule,’’ MacDonald said.
A smear test took about 15 minutes, so letting people do it at home, or by themselves in the bathroom at their GP’s practice, would free up medical practitioners’ time, she said.
The change was first promised in 2017 but attempts to get the programme funded in 2018, 2019 and 2020 were rejected.
‘‘It is overdue,’’ MacDonald said. ‘‘But we understand that a
lot of thought and money needs to go into developing these complicated IT systems.’’
MacDonald urged women not to wait until the new method came into effect to get tested. ‘‘Waiting two years may potentially mean women have pre-cancer that develops into cancer.’’
When Allan posted in April on social media about her diagnosis she wrote: ‘‘I am one of those gals that hates anything to do with ‘down there’. And have taken a ‘see no evil, hear no evil’ type approach to that part of my body. Time passes. Work piles on. Going to the doctor for anything other than an emergency goes way down the priority list.’’
Speaking at Kokiri Marae in Lower Hutt yesterday, Verrall said the investment would fund a new software system and patient register crucial to the programme. The Ministry of Health would also consider options to mailing out selftesting kits. Clinical modelling predicted the change would prevent an additional 400 cervical cancers in 17 years, saving about 138 additional lives. A third of these are expected to be wa¯ hine Ma¯ ori.
Research has shown Ma¯ori are less likely to get a test under the current programme. It was about more than not having the time or money; it was about whakama¯ (shame, embarrassment) and ideas around bodily autonomy, MacDonald said.
Research by Massey University, Waitemata¯ District Health Board and Auckland District Health Board, found Ma¯ ori were nearly 10 times more likely to take a self-test rather than have a standard cervical smear.