Cervical cancer screening, hospital safety and quality assurance, and best practice in treating depression.
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What is the overall focus of today’s Health Report episode?
Hi, it's Norman Swan here. Before I let you get to this week's health report, I want to give you a personal recommendation for another great podcast from Radio National. Indeed, a show I hosted for about five years. It's Life Matters. It delves into what makes humans tick, not sick, but tick, and it's life, not always as you know it. So look for Life Matters on the RN website, ABC radio app, or wherever you listen to podcasts. But now, here comes the health report. Hello and welcome to this week's Health Report with me, Norman Swan. Today, behavioural activation, a simpler, cheaper form of psychotherapy for depression. How to make our healthcare system, especially our hospitals, safer? Could Victoria show us the way after a disaster in one of their maternity services?
And cervical cancer, cancer in the neck of the uterus, is a nasty malignancy which is hard to treat, but luckily it's preventable by screening. For many years, Australia has been a world leader in cervical cancer screening using the so-called pap smear, looking for rogue cells under the microscope. The result has been very low rates of invasive cervical cancer by international standards. But for next year, cervical cancer screening will undergo a radical change and some have asked whether it will be safe. A paper in this morning's Medical Journal of Australia has tried to answer that question. And one of the authors, Karen Canfield of the Cancer Council New South Wales, is in the studio with us, as is Jonathan Carter, Director of Gynaecological Oncology at the Chris O'Brien Lifehouse Cancer Centre in Sydney.
Welcome to the Health Report, both of you.
Thanks,
Norman. Jonathan, what are the changes from next year?
Well, up until now, the pap smear screening system, which originated back in the 1990s as a national and coordinated approach, involved pap smears for women aged from 18 onwards every two years. And whilst that has been a great step forward with a reduction in the incidence of about 50% in patients developing cervical cancers, That incidence has plateaued over recent years. And so the current recommendations, which will be coming to effect in May of next year, involves a test called the HPV test, which is kind of like from the pap test. It's not a blood test. So
you're
scraping the cervix as well? women will be invited to have an HPV test. From the age of 25. From the age of 25. And if that HPV test is positive, they'll have a reflex smear and colposcopy.
And so the difference, apart from the HPV testing, so it's every five years?
Yes.
And it's by invitation. So at the moment, unless you've got a really good GP who has a system for recall, it's up to the woman to actually remember to go along
to have a smear. Yes, that's
correct. So the worry is younger women, maybe you're neglecting younger women. There's the issue of interval cancers. If it's 75 years, are you going to get developed cancer
in
between times? And it's the younger woman, Karen, that you've been looking at in the study in this week's Medical Journal of Australia. Tell us about the study.
Well, that's right, Norman. So what we've done is on the threshold of these major changes, we've done a 25-year look back essentially. So we looked at the performance of the National Cervical Screening Program in women of different ages over the time since the program was initiated. So it's
1988 or something like that?
Yeah, from the late 80s.
How will Australia’s cervical cancer screening program change next year?
The program was initiated in 91 and we looked at the performance of the program over 20 years. And we found... And just by
way of background, we've probably been over-testing even by pap smear standards because what Finland's been doing once every three years for a long time
and
they've got lower rates than us.
That's right. And in fact, the international recommendations are to screen only every three years in younger women with pap smears and to start at age 25 even with pap smears.
But when we suggested that in Australia, there was World War III with a pathologist and some gynaecologists.
Well, I think what's changed is a couple of things.
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Chapters
8 chapters
1
What is the overall focus of today’s Health Report episode?
0:00–3:37
2
How will Australia’s cervical cancer screening program change next year?
3:37–7:17
3
What does the new 25‑to‑75‑year HPV screening study reveal about younger women?
7:17–10:44
4
Why is hospital safety and quality governance a priority after the Victoria maternity tragedy?
10:44–14:14
5
What recommendations did the ‘Targeting Zero’ review make to improve hospital safety?
14:14–18:08
6
What is behavioural activation and how does it differ from traditional CBT for depression?
18:08–21:54
7
What were the key findings of the Lancet trial comparing behavioural activation to CBT?
21:54–25:17
8
How might non‑specialist delivery of behavioural activation improve mental‑health access?
25:17–28:52
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