As Australia is set to become one of the first countries to eliminate cervical cancer, Aboriginal and Torres Strait Islander women are being left behind.
A new study from the the Australian National University (ANU) and Cancer Council NSW (CCNSW) notes that immediate changes to services and structures are necessary for the cervical health of Aboriginal and Torres Strait Islander women.
The research was led by Torres Strait Islander woman and Associate Professor Lisa Whop from ANU and Dr Megan Smith from CCNSW.
“Despite Australia who will probably be one of the first countries in the world to eliminate cervical cancer, the stark reality is that Indigenous women are not on track to reach the elimination target,” said Assoc. Professor Whop.
“But because Aboriginal and Torres Strait Islander women are a small proportion of the population that huge inequity gets masked.
“This plays out here in Australia, in New Zealand, Canada and the US, you can’t avoid knowing that this is a racialised health inequality.”
Human Papillomavirus (HPV) is a common sexually transmitted infection and is the cause of all cases of cervical cancer as well as 90 per cent of anal cancers and genital warts.
The World Health Organisation (WHO) has developed a three-target strategy to eliminate cervical cancer for each country to achieve by 2030.
The targets include seeing 90 per cent of women vaccinated against HPV, 70 per cent of women screened twice in their lifetime for HPV and 90 per cent of women having access to treatment.
Assoc. Professor Whop is concerned that Aboriginal and Torres Strait Islander women will continue to be affected by cervical cancer beyond Australia’s elimination.
“As someone who leads the team of researchers that focus solely to ensure that we are part of elimination for Indigenous women, I’m worried that when we reach elimination, the focus will be gone,” she said.
“People are obsessed with Close the Gap, but cancer overall is actually increasing for Indigenous people but decreasing for non-Indigenous people. The gap is widening, this is one cancer we can do something about.”
Public Health messaging plays an instrumental role in getting patients through the door and into clinics. However, the current strategy isn’t working for First Nations women.
“Cervical cancer can be eliminated if we vaccinate, screen and treat but we are just not adequately doing those three things for Indigenous populations,” she said.
“What we know from research [and] the literature shows consistently, is that if you create public health programs based on those who need it the most, those on the fringes. It works best for everyone.”
Currently there is no government-recorded data around the impact of cervical cancer programs on Aboriginal and Torres Strait Islander women.
“It really shows the way that our society values Blak women. We have had a national program since 1991 which has never reported on how the screening programs meets the needs of Indigenous women,” she said.
“The only population estimates we have ever seen is by research I did a few years ago. For me, that is not good enough.
“This is definitely a story of unacceptable and horrific inequality.”
Technology around HPV screening has enabled women to self-collect testing kits through the Government’s National Cervical Screening Program, which makes a very invasive and potentially triggering experience, safer.
“The technology around self-collection makes screening so much more accessible not just for Aboriginal and Torres Strait Islander women but for all women,” she said.
“What we want is for every five years for women to take those five minutes, one screening can save your life.
“In five to 10 years I’d like to see a policy change so all women can access self-collection. Women need options, they need to be valued.”
By Rachael Knowles