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Dr Bev Lawton holds up a test tube in front of some rolling green hills of rural Otago
Dr Bev Lawton holds one of the new cervical screening tests

SocietyApril 12, 2023

The struggle for access to cervical screening in rural Aotearoa

Dr Bev Lawton holds up a test tube in front of some rolling green hills of rural Otago
Dr Bev Lawton holds one of the new cervical screening tests

The smear test is about to get a major revamp – but if you live rurally the same problems remain. 

The new cervical screening test just months away, which is relevant news to anyone who has a cervix, is sexually active and is aged between 25-69 in Aotearoa. Although the new HPV tests will be quicker, more accurate and more comfortable, researchers and women’s health experts remain critical of the barriers that remain – there will still be a cost associated for most patients, and the test will have to (initially, at least) take place at the doctor’s office.

There is also the added problem of location, an issue explored in a new documentary that highlights the unique access challenges faced by patients who live rurally in Aotearoa. Filmed during the annual Shear-a-thon in Moa Flat, Central Otago, a group of health practitioners and researchers set up a mobile cervical testing unit for the weekend, providing access for patients that would otherwise be facing a 90 minute drive to get tested. 

“You’ve got to take the day off work, you’ve got to have someone look after your kids, you’ve got to have a car, you’ve got to have petrol,” Dr Helen Paterson explains. As a point of comparison, patients who live in Dunedin can expect to pay around $80 for the cervical screening appointment. For those who live in Central Otago, the overall expense including travel costs and wages lost can amount to hundreds of dollars for a single appointment.  

“It’s not that you don’t want care,” says one interviewee. “It’s just easier not to do it.”

Shearer Tes Paewai further details the reality faced by many women shearers when it comes to their three-yearly (soon to be five-yearly) test: “A lot of shearing gangs work all year round, seven days a week,” she says. Only having available appointments during the day also means that shearers will have to take the whole day off work. “So then you are missing out on a whole day’s pay, which most shearers don’t want to do because it is hard times at the moment.” 

Dr Bev Lawton, director of Te Tātai Hauora o Hine (the National Centre for Women’s Health Research Aotearoa), was onsite for the weekend, and heard these stories first hand. “You talk to the wāhine and their whānau and there is such an issue for them to get the help they need,” she says. “It’s not that they don’t care, it’s that the system doesn’t currently provide what they need.” 

Dr Bev Lawton helps out with the pop-up testing clinic.

One woman who visited the mobile unit over the course of the weekend had never had a test before in her life, which Lawton says highlights the need for a more flexible and varied rollout of the programme in different communities. “The rural community really embraces these different ways of doing things,” she says. “There was a very strong positive response to the bus, proving that this was a highly feasible model.”

The new cervical screening programme, set to launch in July, is a huge opportunity for Aotearoa to completely eliminate a disease which affects around 160 women a year and kills around 50, says Lawton. “Still, we need a programme that meets the needs of those at the moment who aren’t regularly screening,” she adds. We know if we make it more easily accessible, then everybody benefits.”

Although accessibility hurdles will still remain for those living in rural areas when the new testing programme launches in July, Lawton says there needs to be more awareness around the huge step forward that it represents. “I think everyone needs to be champions of this, because we’ve got a WHO call to eliminate cervical cancer and we might be able to see the end of it. Every woman, every man, every whānau should know about this.”

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