Implementation of self-collected cervical screening in an under-screened, culturally and linguistically diverse antenatal population: a quality improvement study

Implementation of self-collected cervical screening in an under-screened, culturally and linguistically diverse antenatal population: a quality improvement study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 12 May 2026 V1 Latest version Share on Implementation of self-collected cervical screening in an under-screened, culturally and linguistically diverse antenatal population: a quality improvement study Authors : Mandy Wang 0000-0002-6509-6926 [email protected] , Alison Brand [email protected] , Martin Plymoth [email protected] , Judy Chen [email protected] , and Therese McGee [email protected] Authors Info & Affiliations https://doi.org/10.22541/authorea.15003191/v1 11 views 5 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective To improve cervical screening uptake through implementing a comprehensive program embedding self-collected cervical screening tests (SC-CST) into antenatal care. Design Prospective quality improvement study. Setting Tertiary hospital servicing a population with one of the lowest cervical screening rates nationally. Population Pregnant women attending public maternity care and eligible for screening under national guidelines. Methods Screening histories were obtained from the national registry to identify screen-overdue or never-screened women for SC-CST offer. Staff education and patient information encouraged participation. Test packs facilitated specimen collection for human papillomavirus (HPV) testing. Referral pathways were created for abnormal results. Main Outcome measures Reach, effectiveness, implementation, and maintenance of quality improvement. Results From 19/2/2024 to 31/7/2025, 48.1% (2492/5190) of eligible pregnant women required a CST, 69.7% were offered SC-CST, and 93.7% accepted. Cervical screening rates increased 22-fold from 3.0% prior to the program to 65.3%. Parous women were offered SC-CST at lower rates than nulliparous women (66.5% vs 74.1%; p=0.024). Women residing in the lowest socioeconomic quintile had lower acceptance rates (91.9% vs 94.8%; p=0.024). Being overseas-born and need for interpreter were not barriers to SC-CST offer or acceptance rates. Results were high risk HPV-negative in 88.1%, HPV 16/18 positive 1.9%, HPV non-16/18 positive 9.1%, and invalid 0.9%. Colposcopy was performed for 41 women, with 7 cases of biopsy-confirmed high-grade squamous intraepithelial lesion requiring treatment. Conclusions Introduction of SC-CST into antenatal care is an effective strategy to improve cervical screening rates and was highly acceptable to pregnant women. Program sustainability requires additional resources, staff engagement, and timely follow-up. Supplementary Material File (s1 supplementary table 1.docx) s1 supplementary table 1 Download 19.80 KB File (s2 supplementary figure patient info sheet.jpg) s2 supplementary figure patient info sheet Download 181.40 KB File (s3 supplementary figure staff education.jpg) s3 supplementary figure staff education Download 223.84 KB File (s4 supplementary table 2.docx) s4 supplementary table 2 Download 15.89 KB Information & Authors Information Version history V1 Version 1 12 May 2026 Keywords DELIVERY: CAESAREAN SECTION FETAL MEDICINE: UTEROPLACENTAL INSUFFICIENCY HAEMATOLOGY: COAGULATION IMMUNOLOGY MEDICAL DISORDERS IN PREGNANCY MISCARRIAGE MISCARRIAGE: RECURRENT OBSTETRIC HAEMORRHAGE PRE-ECLAMPSIA: CLINICAL RESEARCH PRETERM LABOUR: CLINICAL RESEARCH PRETERM LABOUR: BASIC SCIENCE EPIDEMIOLOGY: PERINATAL FETAL MEDICINE: ALLOIMMUNISATION ANTENATAL CARE CYTOLOGY: CERVICAL CYTOLOGY: SCREENING DELIVERY: CAESAREAN SECTION FETAL MEDICINE: UTEROPLACENTAL INSUFFICIENCY HAEMATOLOGY: COAGULATION IMMUNOLOGY MEDICAL DISORDERS IN PREGNANCY MISCARRIAGE MISCARRIAGE: RECURRENT OBSTETRIC HAEMORRHAGE PRE-ECLAMPSIA: CLINICAL RESEARCH PRETERM LABOUR: CLINICAL RESEARCH PRETERM LABOUR: BASIC SCIENCE EPIDEMIOLOGY: PERINATAL FETAL MEDICINE: ALLOIMMUNISATION ADENOMYOSIS: BASIC SCIENCE Authors Affiliations Mandy Wang 0000-0002-6509-6926 [email protected] View all articles by this author Alison Brand [email protected] View all articles by this author Martin Plymoth [email protected] View all articles by this author Judy Chen [email protected] Westmead Hospital Women's & Newborn Health Department, Westmead, Australia, 2145 View all articles by this author Therese McGee [email protected] View all articles by this author Metrics & Citations Metrics Article Usage 11 views 5 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Mandy Wang, Alison Brand, Martin Plymoth, et al. Implementation of self-collected cervical screening in an under-screened, culturally and linguistically diverse antenatal population: a quality improvement study. Authorea . 12 May 2026. DOI: https://doi.org/10.22541/authorea.15003191/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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