Preventing Cervical Cancer: NCSR

When it comes to cervical cancer, Australia is fortunate enough to have the lowest mortality rate, and second lowest incidence rate in the world. While these are encouraging statistics, the success of our cervical screening program is heavily dependent upon the recruitment of women.

 Higher rates of participation in cervical screening means that more women with precancerous abnormalities can be detected and treated sooner, which is necessary to achieve lower incidence and mortality from cervical cancer.

Cervical Screening Rates In Your Practice

What are the cervical cancer screening rates in your practice? More importantly, how do they compare to other practices in your PHN or the  national average?

What, if any, have you found are the limitations in improving screening rates within your practice? Can you articulate the barriers to cervical screening in your practice? Is it perhaps a lack of patient education around the importance of cervical screening? Are there cultural barriers in place?

Is Preventative Healthcare Part of Your Practice’s Workflow?

Nationally, cervical cancer rates are declining. Some drivers behind this include the widely available HPV vaccination, the option for  cervical cancer screening self-collection, and the initiative to offer cervical screenings every 5 years. However, even with all the above, our national rate of screening is less than 50%; and I tend to be a glass half empty sort of person!

At our practice in Campsie, less than half of our female population were involved in cervical screening. We averaged approximately 30% for our PHN, compared to the national average of around 40%. So naturally the question came to mind – what were some of the barriers that our women patients were facing? We decided to embark on a quality improvement activity with  NPS MedicineWise Learning to ascertain how we could improve these rates.

The most welcomed upgrade and recently added feature in Bp Premier Saffron was the NCSR integration – or National Cancer Screening Register. Instead of having our nurses call and be on hold with the NCSR, we can now readily access information through Bp Premier. In fact, we are able to do everything related to cervical screening directly within Bp Premier; from the utilities function, to searching the NCSR hub for most recent screening dates, results and even to check when women were next due, or if they were overdue and required a recall.

We could finally update our database to reflect our true cervical screening rates and actively recall women who were due for screening. This was particularly important post-lockdowns, where ‘less important’ things like screening may not have been front of mind. I believe our cervical screenings rates are now higher than before, due to information previously being missing, incomplete or out of date. Bp Software  provides several SQL queries that have proven useful for us in accomplishing this task.

NCSR Integration – Where To From Here?

Quality improvement is something that exists on a timeline. It can’t be set and forget. As for our practice’s approach:

• We plan to revisit our cervical screening every 6 months to capture any data that is missing
• We plan to include cancer screening records for all new patients when they meet with our nurses
• We would like to tackle bowel screening rates
• We look forward to the NCSR integration with Breast Screen
• We would like to see NCSR reminders in Bp Premier generated as a list, without having to enter the reminders ourselves
• We are fortunate and privileged to live in a country that offers free screening for prevention of these cancers, most of which have great treatments if identified early. 

As the adage goes; prevention is better than cure.

Dana Tse 
NSW/ACT State Committee Member Australian Association of Practice Management