{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T14:52:16Z","timestamp":1793890336304,"version":"4.8.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Australia's human papillomavirus (HPV)\u2010based National Cervical Screening Program guidelines state that anyone eligible for screening should be offered a choice of using self\u2010collection or clinician collection for initial screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the awareness and experiences of women and people with a cervix who have been screened since this choice became available in July 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured online or telephone interviews were conducted between February and May 2024 with 43 Victorian women and people with a cervix, aged 25\u201374\u2009years. All participants self\u2010reported completing a cervical screen within 12 months of our study. Interview data were recorded, transcribed verbatim and thematically analysed before being mapped to The Ottawa Decision Support Framework. Self\u2010reported screening history was confirmed with de\u2010identified data from the National Cancer Screening Register (NCSR) Victorian Raw Data Extract (November 2024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fewer than half (19, 44%) of those interviewed were given a choice at their most recent screen, with variation in how options were presented by healthcare providers. Participants felt they lacked awareness and knowledge to feel confident in their options.<\/jats:p>\n                    <jats:p>Most participants viewed having a choice as important and, even if they did not prefer self\u2010collection for themselves, noted benefits for others. Some felt disappointed or angry about not having a choice, while others were happy to defer to their doctor.<\/jats:p>\n                    <jats:p>Relationships with, and the views of, healthcare providers strongly influenced decision\u2010making. Participants reflected on potential advantages of self\u2010collection if it could reduce the cost of appointments and be accessed in more flexible ways.<\/jats:p>\n                    <jats:p>Among the 38 participants who consented to screening history verification, the self\u2010reported data showed reasonable accuracy (67%) against the NCSR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a clear policy directive for practitioners to offer a choice to all eligible individuals, many recent screeners were not offered the choice or lacked the knowledge, confidence and decision supports needed to make an informed choice. The choice of screening method appears strongly influenced by if, and how, options are presented by healthcare providers. A range of strategies are needed to ensure screeners feel empowered, supported and informed to make and carry out a real choice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Members of the public were involved in interviews. Findings were summarised and disseminated via a short report. A consumer advisory panel provided feedback on the content, readability and length of all patient\u2010facing resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70397","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T01:28:17Z","timestamp":1755653297000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["\u2018\n                    <i>Why Didn't I Get That Choice?\u2019<\/i>\n                    : A Qualitative Exploration of How Cervical Screening Choices Are Understood and Experienced by Screen\u2010Eligible People in Australia, Two Years After Self\u2010Collection Became an Option for All"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3211-6644","authenticated-orcid":false,"given":"Ana Machado","family":"Colling","sequence":"first","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3702-9029","authenticated-orcid":false,"given":"Tessa","family":"Saunders","sequence":"additional","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Creagh","sequence":"additional","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maleeha","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2304-3105","authenticated-orcid":false,"given":"Julia","family":"Brotherton","sequence":"additional","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Cancer Council Australia. Cervical Cancer Screening Program Guidelines cited March 6 2025 https:\/\/www.cancer.org.au\/clinical-guidelines\/cervical-cancer\/cervical-cancer-screening."},{"key":"e_1_2_13_3_1","unstructured":"Department of Health and Aged Care. Australian Government Department of Health and Aged Care. 2021. Self Collection to Increase Choice Within the National Cervical Screening Program Cited March 14 2025 https:\/\/www.health.gov.au\/news\/self-collection-to-increase-choice-within-the-national-cervical-screening-program."},{"issue":"3","key":"e_1_2_13_4_1","first-page":"5","article-title":"A Simple Approach to Shared Decision Making in Cancer Screening","volume":"24","author":"Schrager S. B.","year":"2017","journal-title":"Family Practice Management"},{"key":"e_1_2_13_5_1","unstructured":"Australian Institute of Health and Welfare. National Cervical Screening Program Monitoring Report 2024 cited March 6 2025 https:\/\/www.aihw.gov.au\/reports\/cancer-screening\/ncsp-monitoring-2024\/report-editions."},{"key":"e_1_2_13_6_1","unstructured":"Understanding the NCSP Program Management Pathway: A Guide for Healthcare Providers. National Cervical Screening Program.https:\/\/www.cancer.org.au\/assets\/pdf\/understanding-ncsp-management-pathway."},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51137"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10040-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-068582"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY20209"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7254"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11554-6"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003743"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpja.280"},{"key":"e_1_2_13_15_1","unstructured":"Cervical Screening Test Self\u2010Collection Uptake Report Cited March 6 2025 https:\/\/www.health.gov.au\/sites\/default\/files\/2024-12\/update-on-cervical-screening-self-collection-uptake.pdf."},{"key":"e_1_2_13_16_1","unstructured":"Australian Government Services Australia. Medicare Item Reports Cited March 6 2025 http:\/\/medicarestatistics.humanservices.gov.au\/statistics\/mbs_item.jsp."},{"key":"e_1_2_13_17_1","unstructured":"New Zealand Government. Strong Uptake for Cervical Screening Self\u2010Test cited March 6 2025 https:\/\/www.beehive.govt.nz\/release\/strong-uptake-cervical-screening-self-test."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-04-24-7229"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X20911870"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_13_22_1","unstructured":"National Cancer Screening Register. About the National Cancer Screening Register cited April 18 2025 http:\/\/www.ncsr.gov.au\/about-us.html."},{"key":"e_1_2_13_23_1","unstructured":"Data Requests. ACPCC cited April 18 2025 https:\/\/acpcc.org.au\/services\/population-health\/data-requests\/."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/16094069231205789"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1479-3709(07)11003-7"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fnhli.2023.100002"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13258"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH24033"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13961"},{"key":"e_1_2_13_31_1","unstructured":"ACON. Own It\u2014It's Your Cervical Screening Test cited March 6 2025 https:\/\/ownit.org.au\/."},{"key":"e_1_2_13_32_1","unstructured":"Cancer Council Victoria. 2024. Cancer Council Victoria Launched the \u201cIn Your Hands\u201d Cervical Screening Campaign This Month cited March 6 2025 https:\/\/www.cancervic.org.au\/about\/our-history\/history-in-the-present\/cancer-council-victoria-launched-the-in-your-hands-cervical-screening-campaign-this-mont.html."},{"key":"e_1_2_13_33_1","unstructured":"Australian Government Department of Health and Aged Care. Australian Government Department of Health and Aged Care. 2024. Resources cited March 6 2025 https:\/\/www.health.gov.au\/resources."},{"key":"e_1_2_13_34_1","unstructured":"Australian Centre for the Prevention of Cervical Cancer. Clinical Resources cited March 6 2025 https:\/\/acpcc.org.au\/practitioners\/clinical-resources\/."},{"key":"e_1_2_13_35_1","unstructured":"GPEX. 2023. Breast Bowel and Cervical Cancer Screening cited March 6 2025 https:\/\/gpex.com.au\/course\/breast-bowel-and-cervical-cancer-screening-clinical-education-module\/."},{"issue":"1","key":"e_1_2_13_36_1","first-page":"CD001431","article-title":"Decision Aids for People Facing Health Treatment or Screening Decisions","volume":"1","author":"Stacey D.","year":"2024","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.22514\/ejgo.2024.119"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.70191"},{"key":"e_1_2_13_39_1","unstructured":"National Cancer Screening Register. Participant Portal cited March 6 2025 http:\/\/www.ncsr.gov.au\/information-for-participants\/participant-portal.html."},{"key":"e_1_2_13_40_1","unstructured":"National\u2010Strategy\u2010for\u2010the\u2010Elimination\u2010of\u2010Cervical\u2010Cancer\u2010in\u2010Australia.pdf Cited March 7 2025 https:\/\/www.health.gov.au\/sites\/default\/files\/2023-11\/national-strategy-for-the-elimination-of-cervical-cancer-in-australia.pdf."},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2008.17.20.31642"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.13084"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000979"},{"key":"e_1_2_13_44_1","unstructured":"Australian Institute of Health and Welfare. 2023. National Cervical Screening Program Monitoring Report 2023 Summary cited April 2 2025 https:\/\/www.aihw.gov.au\/reports\/cancer-screening\/ncsp-monitoring-2023\/summary."}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T17:10:21Z","timestamp":1765991421000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/hex.70397"],"URL":"https:\/\/doi.org\/10.1111\/hex.70397","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6515903\/v1","asserted-by":"object"}]},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-05-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70397"}}