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Monday, 16 June 2003
Page: 16374


Ms VAMVAKINOU (1:27 PM) ——I was happy to second this motion by the member for Charlton, who is well known in this place for her passionate advocacy for women's health issues. As has been said by the two previous speakers, cervical cancer is one the most preventable and curable of all cancers. However, it remains the eighth most common cancer amongst Australian women. Every year more than 1,000 women face diagnosis of cervical cancer, with over 300 dying from the disease.

A method for detecting cervical cancer in its early stages was developed in the 1920s by Dr George Papanicolaou. This significant screening procedure came to be known as the pap smear. It involves collecting cells from the cervix wall, placing them on a glass plate and sending them off to the lab for examination. Over the last 80 or so years the method and the nature of the test has changed very little, and it has in fact been a very effective test for screening for cervical cancer. As has been stated, up to 90 per cent of the most common form of cervical cancer can be prevented through early detection and early treatment. The operative word here is `early', because early detection of any cancer is the key to maximising best chances of survival. As I said, the pap smear has served us all very well.

In 1991, the federal Labor government set up the National Cervical Screening Program. The incidences of cervical cancer and related mortality have been falling ever since. The program is one of our great national health success stories, encouraging Australian women to have pap smears every two years by educating them on the benefits of the regular tests throughout their entire lives. It is recommended that once women become sexually active they need to have regular two-yearly pap smears. Women should have their first check-up around age 18 or a year or two after first becoming sexually active. Pap smears should be regular, as chances of contracting the disease increase with age.

The success of the program was augmented through the 1998 national advertising campaign. The aim was to bolster screening rates and to raise awareness. State and territory statistical reports now show that the current national screening rate is approaching 70 per cent. The focus of the program was on women between the ages of 35 to 70, who were found to access screening less frequently than younger women.

The incidence and mortality from cervical cancer have fallen steadily from about 1992, with a drop in incidence of 6.2 per cent and a decrease in mortality of 4.2 per cent per annum. The preventative nature of the Cervical Screening Program works to maintain women's health and prevents further medical and financial costs. Women undergo this test for peace of mind, but, like all tests, the effectiveness of the pap smear depends on the cytologist's reading. Increasingly there is concern that the current manner of collecting cells and placing them on a film of glass does not offer cytologists the best and clearest scope for reading or analysing the cells. As a result, the margin of error can result, as has been shown in recent American data, in a large number of women being diagnosed with cervical cancer as a result of wrong diagnosis.

In recent years we have seen an extension of the standard pap smear develop into what is known as ThinPrep. Although direct examination of the cervix has not been replaced, technological advances have changed the way tests are conducted and screened. ThinPrep involves the collection of residual cells that would otherwise be discarded during the pap smear, floating them in liquid and sending them to the lab for examination. Doctors and cytologists agree that this method is far more effective because it provides better clarity. Cytologists can see the cells better and, therefore, the chances of accurate readings are increased and the chances of wrong readings are, of course, decreased.

Many Australian women are now choosing the more accurate but costly ThinPrep test for screening, but women who want their slides prepared for ThinPrep have to pay an extra $20 for the service. The motion before us calls on the government to allow free access to the more reliable ThinPrep test for all Australian women. The test is endorsed by the medical profession, offers greater accuracy and, from what I am told by my own GP, is preferred by cytologists. In the long run, its wider use and application would have benefits for all.

Doctors do not see a situation, of course, where the ThinPrep necessarily replaces the pap test; it is just a case of giving women the opportunity to take advantage of advances in screening technology. Women must be given the freedom to choose the best possible care without the worry of financial constraints. As policy makers, we have a responsibility to facilitate access to improved medical practices and technology which are for the benefit of all Australians. I endorse the motion and call on the government to make this test available free of charge to all women.