NCSP Sector Update – March 2023

Months of planning, coordination and training has seen the 'Ride for Talei' crew successfully cycle the 869-kilometre journey Wellington to Auckland, in efforts to spread the important message of cervical screening across Māori communities.

The kaupapa, led by the Smear Your Mea Trust and led by Te Ururoa Flavell, departed from Waitangi Park, Wellington, on Tuesday, 14 February. 16 cyclists and 10 support crew carried the haerenga north, sharing the legacy left by Talei Morrison - a kapa haka extraordinaire who lost her battle to cervical cancer in 2018.

Before passing, Talei was a strong advocate of cervical cancer prevention through regular screening. The team traversed 8 days, 9 nights, 20 rohe visits, and 869 kilometres of road to tread as the roopu made their way north, carrying Talei’s mauri (spirit) north to the Te Matatini Pōwhiri on Tuesday, 21 February.

Free cervical screening was provided throughout the ride and at Te Matatini Kapa Haka Festival at Ngā Ana Wai – Eden Park by ProCare and Tāmaki Mākaurau providers.

A hugely successful and heartfelt reach to have so many wāhine and whānau be a part of the kaupapa whether directly through the ride or via the many events and clinics held in support across the mōtu. The kaupapa not only witnessed the cycle north, but also many efforts from organisations, gyms and whānau to host similar awareness-raising kaupapa to encourage wāhine Māori to screen.

The Smear Your Mea trust would like to extend a huge mihi to Te Whatu Ora for the support and also to the health providers across the nation for their support of this important kaupapa.

The Road to Rollout HPV primary screening will begin to roll out in Aotearoa New Zealand in late July 2023 – just over four months from now.

It will bring new pathways that empower participants with choice; aims to increase participation in the most under-screened and unscreened populations and decrease barriers to entry for all participants. Enhanced health equity for wāhine Māori and Pacific women is being targeted through less-invasive clinical pathways combined with targeted outreach to the under-screened population.

We are looking to arrest a trend of declining cervical screening coverage for all participants that has persisted over the past eight years, with a greater decline for Māori and Pacific women. Boosting screening numbers will help align us to the World Health Organisation (WHO) global strategy to “eliminate cervical cancer as a public health problem, [by achieving] an incident rate of less than 4 in 100,000 women”. Te Whatu Ora has been making great progress through implementation of cervical screening to bring this down but more needs to be done to achieve the WHO goals and close the gap between different ethnic groups across NZ.

To that end, adopting HPV as a primary screening tool is predicted to result in a 19% reduction in cervical cancer mortality.

We can share with you some of the work that is going on behind the scenes to make this a reality, with the help of the sector. In order to support ramping up to roll out to late July 2023, the Project Team has been refined into working across seven workstreams to ensure we have all aspects covered and to bring together key areas in the development and delivery of HPV primary screening.

These workstreams are:

• the creation of the new NCSP-Register
• laboratories, colposcopy and primary care
• change needs and training for the health sector
• support needs (Support to Screening, clinical and system support)
• data storage and monitoring
• clinical and equity guidelines, including safety monitoring, and
• campaigns and public-facing resources.

Several working groups have sector representation to assist us with advice and feedback on areas such as the new Register, laboratories transitioning to the new testing pathway, colposcopy, the needs of screen-takers and outreach.

The working groups have visibility over our commitment to equity and of the priority for Māori and Pacific. The design of the new programme is underpinned by our responsibility to Te Tiriti o Waitangi and ensuring equitable health outcomes for Māori. This was reinforced by feedback from organisations and individuals consulted around the new clinical pathway. Consultation also revealed there is strong support for Aotearoa New Zealand to move toward self-testing.

Three research projects are running HPV testing pilots and are feeding their findings back to the Project to inform our work. Similarly, the NCSP Advisory and Action Group, including sector representatives, provides further advice and feedback. Engagement with the sector is occurring through regular NCSP stakeholder hui (Kaimahi SSS, Regional Coordinators and Colposcopy), district cervical screening stakeholder networks, and primary care via presentations at screen-taker updates.

We are on the verge of sharing a lot more exciting information with you about the Road to Rollout. Keep an eye out for further details coming to you later in March.

The HPV Primary Screening Project Team are ramping up our engagement with sector groups to share the latest information on the Road to Rollout. We are starting to schedule attendance at regional screen-taker updates. The purpose of our presentations is to build screen-taker awareness, specifically on the changes, training and support for the transition to HPV primary screening.

We are currently working with regional coordinators in Southland, Hutt Valley, Tairāwhiti, Nelson/Marlborough, Taranaki and Waikato to get dates booked in. We will be attending more hui throughout the regions and will update you when these have been scheduled.

Regular engagement with sector organisations such as Family Planning, GPNZ and the New Zealand College of Midwives is also being planned.

We have created a page on the NSU website with summaries of information from the Goodfellow Unit webinar held in September. The page can be found here and contains:

• A PDF of Dr John McMenamin’s original presentation
• A PDF of questions received from attendees, grouped into relevant sections, and answers provided by our clinical team
• A PDF called Moving to HPV testing for primary cervical screening, which provides more detailed and expanded content than the original presentation, and which the sector can call on as a further resource.

About 1500 health professionals attended the webinar, where we addressed the twin themes of why it is important that people continue to screen between now and the transition to HPV primary screening in late July 2023, and the choices that will be available to participants, including self-testing.

A special shout out to the Te Toka Tumai Auckland and Waitematā Planning, Funding and Outcomes team who provided the webinar. The whole webinar is available to view on Goodfellow here: https://www.goodfellowunit.org/events-and-webinars/cervical-screening-update(link is external) which includes the popular presentations from the Te Toka Tumai Lead Colposcopist Dr Deralee Flower, and HPV self-testing research team at Te Toka Tumai and Waitematā Dr Karen Bartholomew and Nurse Specialist Jane Grant.

If you have colleagues who would also like to receive this monthly update, they can join the distribution list by emailing us at hpvscreen@health.govt.nz.

We really appreciate your feedback and are here to answer any questions you may have.