Main outcome measures: Indirectly estimated percentage of NT Indigenous women in rural and remote areas with a predominantly Indigenous population (accounting for 55% of the NT Indigenous population) who participated in screening, in biennial periods between 1997 and 2004. Participation by all eligible NT women (both Indigenous and non-Indigenous) is also reported by region for the same period.
Results: In 1997–1998, estimated participation for Indigenous women was about half the national rate (33.9% [95% CI, 32.6%–35.2%] v 63.9% [95% CI, 63.8%–63.9%]). Participation increased to 44.0% (95% CI, 42.7%–45.4%) in 1999–2000, and changed little thereafter; participation was higher in the Top End compared with Central Australia, and varied from 16.6% to 75.0% between remote areas. Participation rates for all women living in rural/remote regions were lower than those in urban regions.
Conclusions: Recruitment of Indigenous women for cervical screening has improved since 1999. This may have partly contributed to the fall in their cervical cancer incidence and mortality in recent years. Although in most areas Indigenous participation is lower than national levels, in one area it was considerably higher. Improvements can be achieved by learning from these communities, to further close the gap in morbidity and mortality between Indigenous and non-Indigenous women.
- 1. Australian Institute of Health and Welfare and Australasian Association of Cancer Registries. Cancer in Australia 2001. Canberra: AIHW, 2004. (AIHW Cat. No. CAN 23; Cancer Series Report No. 28.)
- 2. Ferley J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. International Agency for Research on Cancer. CancerBase No. 5, version 2.0. Lyon: IARCPress, 2004. http://www-dep.iarc.fr/ (accessed Nov 2005).
- 3. National Cervical Screening Program. Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen detected abnormalities. Canberra: National Health and Medical Research Council, 2005. http://www.nhmrc.gov.au/publications/_files/wh39.pdf (accessed Nov 2005).
- 4. Condon JR, Armstrong BK, Barnes T, et al. Cancer incidence and survival for Indigenous Australians in the Northern Territory. Aust N Z J Public Health 2005; 29: 123-128.
- 5. Condon JR, Barnes T, Cunningham J, Armstrong BK. Long-term trends in cancer mortality for Indigenous Australians in the Northern Territory. Med J Aust 2004; 180: 504-507. <MJA full text>
- 6. Australian Bureau of Statistics. Regional statistics, Northern Territory, 2005. Canberra: ABS, 2005. (ABS Cat. No. 1362.7. 2005.) http://www.abs.gov.au/Ausstats/abs@.nsf/e8ae 5488b598839cca25682000131612/04c2cf10 fac92ff3ca256ae2007d1c83!OpenDocument (accessed Nov 2005).
- 7. Making a difference for Northern Territory women: six years on. NT Women’s Cancer Prevention Program Report to June 1 1999. Darwin: Territory Health Services, Northern Territory Government, 2001.
- 8. Australian Institute of Health and Welfare. Cervical screening in Australia Series 1998–2003. Canberra: AIHW, 2002-2005. (AIHW Cat. Nos. CAN 11, CAN 19, CAN 22 and CAN 26.)
- 9. Northern Territory of Australia Public Health (Cervical Cytology Register) Regulations. 2005. http://notes.nt.gov.au/dcm/legislat/legislat.nsf/d989974724db65b1482561cf0017cbd2/14763de5528db73c692570e5000acf22/$FILE/Repp023R9.pdf (accessed Sep 2006).
- 10. Edwards R. Australian standard geographical classification (ASGC) 2001. Canberra: Australian Bureau of Statistics, 2001. (ABS Cat. No. 1216.0.)
- 11. Australian Bureau of Statistics. Australian demographic statistics, September quarter 2002. Canberra: ABS, 2002. (ABS Cat. No. 3101.0.)
- 12. Australian Bureau of Statistics. 2001 National Health Survey: summary of results. Canberra: ABS, 2002. (ABS Cat. No. 4364.0.)
- 13. Coory MD, Fagan PS, Muller JM, Dunn NAM. Participation in cervical cancer screening by women in rural and remote Aboriginal and Torres Strait Islander communities in Queensland. Med J Aust 2002; 177: 544-547. <MJA full text>
- 14. Wain G, Morrell S, Taylor R, et al. Variation in cervical cancer screening by region, socio-economic, migrant and indigenous status in women in New South Wales. Aust N Z J Obstet Gynaecol 2001; 41: 320-325.
- 15. Gilles MT, Crewe S, Granites IN, et al. A community-based cervical screening program in a remote Aboriginal community in the Northern Territory. Aust J Public Health 1995; 19: 477-481.
- 16. Hunt JM, Gless GL, Straton JA. Pap smear screening at an urban aboriginal health service: report of a practice audit and an evaluation of recruitment strategies. Aust N Z J Public Health 1998; 22: 720-725.
- 17. Mak D, Straton JA. Effects and sustainability of a cervical screening program in remote Aboriginal Australia. Aust N Z J Public Health 1997; 21: 67-70.
- 18. Mak DB, Straton JA. The Fitzroy Valley Pap Smear Register. Cervical screening in a population of Australian Aboriginal women. Med J Aust 1993; 158: 163-166.
- 19. Guest C, Mitchell H, Plant A. Cancer of the uterine cervix and screening of Aboriginal women. Aust N Z J Obstet Gynaecol 1990; 30: 243-247.
- 20. Couzos S, Wronski I, Murray R, et al. Augmentation of Pap smear screening of high risk aboriginal women. Use of a computerised process tool within the Broome Aboriginal Medical Service. Aust Fam Physician 1998; 27: 269-274.
- 21. Condon JR, Williams DJ, Pearce MC, et al. Northern Territory hospital morbidity dataset: validation of demographic data 1997. Darwin: Territory Health Services, 1998.
- 22. Condon JR, Zhao Y, Armstrong BK, et al. Northern Territory Cancer Register Data Quality 1981–2001. Darwin: Department of Health and Community Services, 2004.
- 23. Yusuf F, Siedlecky S. Hysterectomy and endometrial ablation in New South Wales, 1981 to 1994–1995. Aust N Z J Obstet Gynaecol 1997; 37: 210-216.
- 24. Volkmar-Campbell JV, Kurnoth P. Well women making a difference: evaluation report and program guide. Darwin: Women’s Cancer Prevention Program, Department of Health and Community Services, Northern Territory Government, 2000.
- 25. Gruen RL, Bailie RS, d’Abbs PH, et al. Improving access to specialist care for remote Aboriginal communities: evaluation of a specialist outreach service. Med J Aust 2001; 174: 507-511.
- 26. Bailie R, Sibthorpe B, Anderson I, et al. Data for diagnosis, monitoring and treatment in indigenous health: the case of cervical cancer. Aust N Z J Public Health 1998; 22 (3 Suppl): 303-306.
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