Evidence map›Paper›PMID 29440214›Full record

ArticleBMJ open2018

'It has saved thousands of lives, so why change it?' Content analysis of objections to cervical screening programme changes in Australia.

Helena M Obermair, Rachael H Dodd, Carissa Bonner, Jesse Jansen, Kirsten McCaffery

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In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  8. Why Most Australians Consider It Valuable to Find Harmless Abnormalities with Diagnostic Tests: A Mixed-Methods Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2026
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  10. Recommendations for a Communication Strategy to Support Informed Decision-Making About Self or Clinician Sampling for Cervical Screening in the UK: Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Helena M ObermairSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0217-6574
Rachael H DoddSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-8080-6359
Carissa BonnerSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Jesse JansenSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Kirsten McCafferySchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe 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 18-69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25-74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, 'Stop May 1st Changes to Pap Smears-Save Women's Lives', opposing the changes, which received over 70 000 signatures and almost 20 000 comments.

methodsContent analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February-March 2017.

resultsNineteen codes were identified, reflecting four themes: (1) valuing women's 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's 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.

conclusionsScreening changes within this selected group were perceived as threatening women's 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.

Indexed as

Public OpinionAdolescentAdultAgedAustraliaEarly Detection of CancerFemaleHumansMass ScreeningMiddle AgedPapanicolaou TestPapillomavirus InfectionsPoliticsTime FactorsUterine Cervical NeoplasmsVaginal Smearsgynaecological oncologyhealth policypreventive medicinepublic healthqualitative research

Identifiers

PMID29440214
PMCPMC5829885

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.