title: Clinicians' attitude towards changes in Australian National Cervical Screening Program.
abstract: BACKGROUND
  Australian guidelines for cervical cancer screening are being revised under the "renewal program". Physicians' willingness to accept these changes will play a pivotal role in its success.
  
  
  OBJECTIVE
  To understand the willingness and acceptance of, as well as barriers and facilitators for Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) affiliates to screening using human papillomavirus (HPV) testing, starting at 25 years of age, every 5 years.
  
  
  METHODS
  An electronic survey of RANZCOG affiliates was undertaken April-June 2014, while renew was announced April 28th 2014. Responses used a 7 point Likert scale, which was dichotomized as ≤4, indicating 'unwilling' and >4, indicating 'willing' to adopt revised practices.
  
  
  RESULTS
  Response rate was 22% (n=956): 60% were obstetricians and gynaecologists (OG); 27% general practitioner diplomates; 13% OG trainees. Overall, 60% (n=526/874) were willing to revise their screening practice. This correlated with awareness of new guidelines (p=<0.001). Fifty percent (n=438/869) of respondents were concerned about delaying to 25 years, and 48% (n=421/869) concerned cervical cancers would be missed. Reasons respondents gave for wishing to continue screening from 18 years contrary to guidelines included: women not being vaccinated (65.6%), immunosuppressed women (92.2%) and women who had been victims of childhood sexual assault (73.9%).
  
  
  CONCLUSIONS
  The majority of RANZCOG affiliates were willing to change screening practice however, a number of barriers to delaying onset of screening age to age 25 years were reported. Effective change management strategies will need to be implemented to address the concerns raised to ensure best practice for cervical screening.
authors.affiliation: Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia. Electronic address: Desiree.Yap@thewomens.org.au.
authors.forename: Desiree
authors.initials: D
authors.lastname: Yap
authors.affiliation: Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria, Australia.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Liang
authors.affiliation: Women's Centre for Infectious Disease, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia; Murdoch Childrens Research Institute Parkville, Victoria, Australia.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.affiliation: Women's Centre for Infectious Disease, Royal Women's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute Parkville, Victoria, Australia.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hartley
authors.affiliation: Melbourne EpiCentre, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gorelik
authors.affiliation: Clinical Prevention Services, BC Centre for Disease, University of British Columbia, Vancouver, Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.affiliation: Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tan
authors.affiliation: Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia.
authors.forename: C David H
authors.initials: CDH
authors.lastname: Wrede
authors.affiliation: Dysplasia Unit, Royal Women's Hospital, Parkville, Victoria, Australia; Department of Obstetrics and Gynaecology, Royal Women's Hospital University of Melbourne, Parkville, Victoria, Australia; Department of Gynaecology, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Jayasinghe
mesh_terms: D000367:Age Factors; D001315:Australia; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008403:Mass Screening / Q000331:legislation & jurisprudence / Q000523:psychology*; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D010820:Physicians / Q000523:psychology*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D014611:Vaccination / Q000523:psychology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Cervical screening; Change management; Gynecologist; HPV testing; Human papillomavirus; Obstetrician; RANZCOG; Renew guidelines