{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:44:48Z","timestamp":1789559088622,"version":"build-2803163510"},"reference-count":53,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,11]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18\u201369 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25\u201374 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, \u2018Stop May 1st Changes to Pap Smears\u2014Save Women\u2019s Lives\u2019, opposing the changes, which received over 70\u2009000 signatures and almost 20\u2009000 comments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Content analysis of a random sample of 2000 comments, reflecting 10% of the 19\u2009633 comments posted in February\u2013March 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen codes were identified, reflecting four themes: (1) valuing women\u2019s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women\u2019s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Screening changes within this selected group were perceived as threatening women\u2019s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019171","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T09:09:35Z","timestamp":1518512975000},"page":"e019171","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":96,"title":["\u2018It has saved thousands of lives, so why change it?\u2019 Content analysis of objections to cervical screening programme changes in Australia"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-6574","authenticated-orcid":false,"given":"Helena M","family":"Obermair","sequence":"first","affiliation":[{"name":"School of Public Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8080-6359","authenticated-orcid":false,"given":"Rachael H","family":"Dodd","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carissa","family":"Bonner","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Jansen","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,2,13]]},"reference":[{"key":"2025121515291031000_8.2.e019171.1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.4.244"},{"key":"2025121515291031000_8.2.e019171.2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F"},{"key":"2025121515291031000_8.2.e019171.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.08.017"},{"key":"2025121515291031000_8.2.e019171.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61416-0"},{"key":"2025121515291031000_8.2.e019171.5","unstructured":"Australian Government Department of Health. National cervical screening program. 2017. http:\/\/www.health.gov.au\/internet\/screening\/publishing.nsf\/Content\/future-changes-cervical (cited 3 May 2017)."},{"key":"2025121515291031000_8.2.e019171.6","unstructured":"Australian Institute of Health and Welfare. Cervical screening in Australia 2013-2014. Canberra: AIHW, 2016."},{"key":"2025121515291031000_8.2.e019171.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.11.076"},{"key":"2025121515291031000_8.2.e019171.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"2025121515291031000_8.2.e019171.9","unstructured":"Vesco KK , Whitlock EP , Eder M , et al ; U.S. preventive services task force evidence syntheses, formerly systematic evidence reviews. screening for cervical cancer: a systematic evidence review for the US preventive services task force. 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