Background and rationale
pain
CERVICAL CANCER, CERVICAL CANCER
Cervical cancer is now preventable by vaccination and screening [Cervical cytology is the primary screening method in Aotearoa New Zealand. Switching to HPV testing as the primary screen for cervical cancer prevention has the potential to reduce incident cervical cancers by 15% annually [The current NCSP has significant inequities: 41% of Māori women are under-screened or never-screened compared to 21% of European/other women [The present NCSP involves a speculum exam and taking a cervical sample for cytology, an invasive procedure that requires attending a clinic. For Māori women, barriers to screening include having to attend a clinic, rurality, cost, no transport or time off work, fear of results, and the pain, embarrassment, or discomfort of a genital examination [A new NCSP offering HPV primary testing is planned to be introduced in mid-2023. Aotearoa New Zealand has the opportunity to be one of the first high income countries to switch to HPV self-testing as the primary screening method for cervical cancer prevention.For the new NCSP to be effective, it must be accessible and acceptable to women that the current NCSP fails to reach, particularly Māori and those in rural areas. Such a programme also needs to ensure that any post-screening triage system does not create barriers to diagnostic care [This study will inform how to implement an equitable, high-quality NCSP, utilising a universal offer of HPV self-testing.