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Monday, 16 June 2003
Page: 16376


Ms LEY (1:32 PM) —I rise to support the motion put forward by the honourable member for Charlton. The demand for programs to combat cervical cancer is strong. All across the developing world women's health care providers regu-larly see women with advanced, incurable cervi-cal cancer. Increased participation in cervi-cal screening is important in reducing the number of women who present with this condition and the number who will ultim-ately die of the disease.

Screening to detect abnormalities has been available since the 1960s. In 1995 the National Cervical Screening Program was initiated and included the adoption of a national policy of two-year screening intervals, recruitment programs to encourage high levels of participation by Australian women, and special initiatives to promote high levels of participation among underscreened groups, including older women, women from culturally and linguistically diverse backgrounds, women from Aboriginal and Torres Strait Islander backgrounds, women of low socioeconomic status and women who live in rural and remote areas. The last group is of particular interest to me and my electorate because in the far west of New South Wales we do not have the same access to screening and other health tests as is available to women who live closer to larger cities and on the coast.

The establishment of cervical cytology registries in all states and territories has been an important initiative because these registries promote the regular participation of women and the follow-up of women with abnormal pap smears. They assist with accurate reporting of pap smears by pathology laboratories and facilitate the evaluation and monitoring of the program. There is heightened awareness of the importance of the quality assurance cycle in the screening program, including the development of performance measures for laboratories that report pap smears.

Policy makers and providers in many developing countries are well aware of the toll that cervical cancer takes on women's health and have attempted to develop workable approaches to reduce the morbidity and mortality associated with the disease. However, inadequate attention has been paid to client and provider education about cervical cancer and to the development of effective information systems. In the end it is every woman's responsibility—where they can, where they have the education and where they have the information—to take their health as their own concern and to have regular tests.

Screening and the necessary follow-up care for gynaecological cancers are considered integral parts of reproductive health by a range of international organisations and were included in the program of action adopted at the International Conference on Population and Development. We know that cervical cancer is a significant reproductive health problem. Close to 200,000 women die from the disease each year. It is the third most common cancer worldwide and is the leading cause of death from cancer among women in developing countries.

The pathway to preventing cervical cancer deaths is a simple and effective one. When precancerous changes—which can linger for months or years—in cervical tissue are found and the abnormal tissue is treated, women will not develop this cancer. Screening and treatment services are cost-effective interventions when compared to expensive and often futile hospital based cancer treatments, and they can be integrated with various women's health services at the primary care level.

Overall, it is quite clear that the incidence of cervical cancer can be reduced by appropriate screening, treatment and follow-up techniques. More specifically, to reduce morbidity and mortality, programs must increase awareness of cervical cancer and preventative health seeking behaviour among high-risk women, who are most often in their 30s and 40s; screen a high proportion of women in the target group at least once; treat all women with high-grade dysphasia; and collect service delivery statistics that will facilitate the ongoing monitoring and evaluation of program activities and outputs.

Cervical cancer, as we know, is caused by abnormal cellular changes and it is the only gynaecological cancer that can be prevented by regular screening. Failure to receive regular examination often eliminates the opportunity for early diagnosis by pap smear screening. The policy that was introduced in 1991 introduced the concept of considering cervical screening as a whole program rather than simply a test. Screening in Australia is one of the great public health success stories, as witnessed by the continuing dramatic fall in the incidence of carcinoma of the cervix and mortality from the disease since the introduction of the National Cervical Screening Program.

The motion talks about the ThinPrep pap smear—which enables more than 80 per cent of a woman's sample to be preserved in alcohol—being sent to the lab where obscuring factors are filtered away, which gives a much clearer view of the cervical cells. Universal access to this technology will result in improved health benefits for all Australian women, increase productivity in pathology laboratories and make overall savings in the national health budget. I conclude by re-emphasising that women are responsible for their own health and, where they do have the information and the education, they need to seek out regular screening on their own behalf. (Time expired)