Accuracy of self-reported cervical screening status among pregnant women

Background: Pregnancy provides a special opportunity to improve cervical screening test (CST) uptake and reduce cervical cancer. Screening in Australia is free for Medicare-eligible women ≥ 25 years if performed 5-yearly, but not sooner. Either women's self-reported last CST date or the National Cancer Screening Register (NCSR) can inform screening needs. However, accessing the NCSR is relatively difficult in public antenatal care.Aims: To assess if pregnant women's self-reported last CST year is reliable in determining whether to offer CST in pregnancy or not.Methods: A retrospective Australian hospital study compared the self-reported last CST recorded in the maternity database to NCSR records for all Medicare-eligible women ≥ 25 years booked-in for public antenatal care between 1 June and 30 November 2023.Results: The cohort (n = 1772) had median age 33 years (interquartile range 29–36). Nearly half (n = 862; 49%) were CST-overdue/never-screened. Self-reported last CST dates were concordant with the NCSR for 80% (n = 1420) of participants in terms of needing (35%) or not needing (45%) a CST. However, 244 (14%) over-reported being CST-current when they were actually overdue/never-screened, while 108 (6%) under-reported their CST-currency. Of the 862 women due for a CST, over-reporting represented 28%. If clinicians relied solely on self-reporting, these women would miss out on needed CST screening.Conclusion: Measures to improve the reliability of Australian women's self-reported last CST are needed. This includes clinicians ensuring a woman always knows if a CST has been collected, the NCSR sending CST results to women (not just their practitioners) and promoting easier NCSR database accessibility for women.