Accuracy of Self-Reported Cervical Screening Status Among Pregnant Women

Pregnancy provides a special opportunity to improve cervical screening test (CST) uptake and reduce cervical cancer. Screening in Australia is free for Medicare-eligible women ≥ 25 years if performed 5-yearly, but not sooner. Either women's self-reported last CST date or the National Cancer Screening Register (NCSR) can inform screening needs. However, accessing the NCSR is relatively difficult in public antenatal care.

To assess if pregnant women's self-reported last CST year is reliable in determining whether to offer CST in pregnancy or not.

A retrospective Australian hospital study compared the self-reported last CST recorded in the maternity database to NCSR records for all Medicare-eligible women ≥ 25 years booked-in for public antenatal care between 1 June and 30 November 2023.

The cohort (n = 1772) had median age 33 years (interquartile range 29-36). Nearly half (n = 862; 49%) were CST-overdue/never-screened. Self-reported last CST dates were concordant with the NCSR for 80% (n = 1420) of participants in terms of needing (35%) or not needing (45%) a CST. However, 244 (14%) over-reported being CST-current when they were actually overdue/never-screened, while 108 (6%) under-reported their CST-currency. Of the 862 women due for a CST, over-reporting represented 28%. If clinicians relied solely on self-reporting, these women would miss out on needed CST screening.

Measures to improve the reliability of Australian women's self-reported last CST are needed. This includes clinicians ensuring a woman always knows if a CST has been collected, the NCSR sending CST results to women (not just their practitioners) and promoting easier NCSR database accessibility for women.