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Article summary:

1. Aboriginal and Torres Strait Islander women have higher incidence and mortality rates from cervical cancer compared to non-Indigenous women, despite a national screening program.

2. Self-collection, a vaginal swab taken by the woman herself, is an acceptable way for under-screened Aboriginal and Torres Strait Islander women to participate in cervical screening.

3. Self-collection may provide a mechanism to overcome barriers to participation in cervical screening while enhancing women's sense of control and empowerment.

Article analysis:

The article "Aboriginal and Torres Strait Islander women's views of cervical screening by self‐collection: a qualitative study" explores the perspectives of Aboriginal and Torres Strait Islander women regarding self-collection as part of the renewed National Cervical Screening Program. The study found that most women were unaware of self-collection before the yarn but found it to be an acceptable way to participate in cervical screening. Women perceived self-collection would be convenient, provide a sense of control over the screening experience, and maintain privacy and comfort. However, they had concerns about collecting the sample correctly and the accuracy of the sample compared to clinician-collected samples.

The article highlights the inequitable burden of cervical cancer experienced by Aboriginal and Torres Strait Islander women compared with non-Indigenous women despite a nationally organised cervical screening program introduced in 1991. The study identifies several barriers to cervical screening for Aboriginal and Torres Strait Islander women, including limited access to female healthcare providers, shame, fear, embarrassment, pain, invasion of privacy, distrust of institutions caused by a colonial legacy of intergenerational trauma and experiences of racism in healthcare settings.

The article suggests that self-collection may provide a mechanism to overcome some barriers to participation in cervical screening while enhancing women's sense of control and empowerment. However, evidence demonstrated that self-collection may reduce these barriers. Improving screening in under-screened women is critical as 80% of women who are diagnosed with cervical cancer are overdue for screening or have never been screened.

The article employs yarning (a qualitative method), which established relationships and trust between participants and researchers to facilitate culturally safe conversations. Transcripts were analysed thematically. While a growing body of research suggests that Aboriginal and Torres Strait Islander women find self-collection acceptable in research study settings, self-collection has largely been underutilised in Australia.

Overall, the article provides valuable insights into Aboriginal and Torres Strait Islander women's views on self-collection as part of the renewed National Cervical Screening Program. However, the article could have explored potential biases and their sources, missing evidence for the claims made, unexplored counterarguments, and not presenting both sides equally. The article could have also highlighted possible risks associated with self-collection and provided a more balanced view of the benefits and concerns of self-collection.