How would Australian women and people with a cervix like to access self-collection for cervical screening? Screening preferences from a national survey

PURPOSE: In Australia, cervical screening is usually offered face-to-face through primary care. As self-collection offers flexibility in how and where screening can be accessed, we assessed participant preferences for flexible screening models. METHODS: We recruited women and people with a cervix aged 24-74 years into a national survey (December 2023-April 2024) via a paid Meta campaign and community networks. Sociodemographic factors associated with a preference for appointment- or non-appointment-based models were assessed using logistic regression, stratified by age, < 50 and ≥ 50 years. RESULTS: Among 9,586 respondents, the median age was 41 years, 67.9% lived in a major city, 82.5% were born in Australia, and 62.6% screened regularly. Most (82.6%) viewed flexible options for accessing screening as very important/important. Respondents favored non-appointment-based compared to appointment-based models, with 53.5% of those < 50 (n = 4,842) and 49.5% of those ≥ 50 (n = 1,257) preferring to receive a swab in the mail when due. Non-appointment-based models were preferred by participants aged < 50 and ≥ 50 years who were never-screened (adjOR = 1.52, 95% CI = 1.18-1.96, p = 0.001; adjOR = 2.91, 95% CI = 1.67-5.09, p < 0.001), irregular screeners (adjOR = 1.58, 95% CI = 1.36-1.85, p < 0.001; adjOR = 1.52, 95% CI = 1.17-1.98, p = 0.002) and recently eligible for screening (adjOR = 1.64, 95% CI = 1.08-2.50, p = 0.02) compared to regular screeners. Convenience was the most common reason for participants' preferred screening model (87.4% non-appointment-based; 55.1% appointment-based). CONCLUSION: Flexibility in how cervical screening can be accessed appeals to many screen-eligible people. Further research trialing different models assessing screening uptake and clinical pathways to follow-up care is needed.