How would Australian women and people with a cervix like to access self-collection for cervical screening? Screening preferences from a national survey

TL;DR

Australian women and people with a cervix prefer flexible cervical screening options, such as receiving self-collection swabs by mail, over traditional in-person appointments.

Contribution

The study identifies strong public preference for non-appointment-based cervical screening models, particularly among under-screened and younger populations.

Findings

Most respondents (82.6%) considered flexible screening options very important or important.

Over half of respondents under 50 and nearly half of those aged 50 or older preferred receiving a self-collection swab by mail.

Convenience was the most common reason for preferring non-appointment-based screening models.

Abstract

In Australia, cervical screening is usually offered face-to-face through primary care. As self-collection offers flexibility in how and where screening can be accessed, we assessed participant preferences for flexible screening models.

We recruited women and people with a cervix aged 24–74 years into a national survey (December 2023–April 2024) via a paid Meta campaign and community networks. Sociodemographic factors associated with a preference for appointment- or non-appointment-based models were assessed using logistic regression, stratified by age, < 50 and ≥ 50 years.

Among 9,586 respondents, the median age was 41 years, 67.9% lived in a major city, 82.5% were born in Australia, and 62.6% screened regularly. Most (82.6%) viewed flexible options for accessing screening as very important/important.

Respondents favored non-appointment-based compared to appointment-based models, with 53.5% of those < 50 (n = 4,842) and 49.5% of those ≥ 50 (n = 1,257) preferring to receive a swab in the mail when due. Non-appointment-based models were preferred by participants aged < 50 and ≥ 50 years who were never-screened (adjOR = 1.52, 95% CI = 1.18–1.96, p = 0.001; adjOR = 2.91, 95% CI = 1.67–5.09, p < 0.001), irregular screeners (adjOR = 1.58, 95% CI = 1.36–1.85, p < 0.001; adjOR = 1.52, 95% CI = 1.17–1.98, p = 0.002) and recently eligible for screening (adjOR = 1.64, 95% CI = 1.08–2.50, p = 0.02) compared to regular screeners. Convenience was the most common reason for participants’ preferred screening model (87.4% non-appointment-based; 55.1% appointment-based).

Flexibility in how cervical screening can be accessed appeals to many screen-eligible people. Further research trialing different models assessing screening uptake and clinical pathways to follow-up care is needed.

The online version contains supplementary material available at 10.1007/s10552-026-02128-1.