Cervical screening rates have dramatically increased since 2023 and wāhine Māori can be credited with helping achieve this success. Māori rates for cervical screening have improved significantly to 2026, jumping over 12 points to 69%. The results for Pasifika women are even better, leaping 20 points to nearly 76%.
This drastic improvement comes after a move to a national self-screening programme in 2023 with researcher, Dr Kendall Stevenson (Ngāti Awa, Ngāti Kurī, Ngāpuhi) crediting the input of Te Tai Tokerau wāhine helping make human papillomavirus (HPV) self-testing a reality for the rest of the country. HPV is a virus that can lead to cervical cancer and Kendall was a part of team who wanted to look at ways of improving screening rates.
She was part of Te Tātai Hauora o Hine research team, led by Professor Bev Lawton (Te Aitanga ā Māhaki). In 2017 the team went north to trial a new way of screening with wāhine who were under-screened or had never screened. Wāhine Māori have the highest cervical cancer mortality rate in Aotearoa and addressing this injustice is vital, she says.
Researchers were met with an enthusiastic response from wāhine in Te Tai Tokerau who were keen to share their perspectives and take part in the Health Research Council funded project which was a random controlled trial (RCT) for the HPV self-test, says Kendall.
Many participants expressed a strong desire for screening but the invasive nature of cytology was a significant factor contributing to their hesitancy. Women also reported reluctance in making time for their own health, says Kendall. “We know as māmā, we are often the last to put ourselves first and the need to find childcare while accessing health care adds difficulty for busy mothers. There is also historical trauma regarding women’s health care, particularly cervical cancer, as well as racism that were all parts of the layered reasons Māori women were put off screening with the speculum,” says Kendall.
While clinicians saw screening as a necessary medical procedure, wāhine expressed more nuanced perspectives. “From a women’s perspective, they saw the cytology screening as a highly invasive procedure, forcing them into a vulnerable state, where they lacked bodily autonomy. Some wāhine Māori also talked about the sacredness of their female bodies and how they are literally a portal from one realm to the tapu of te ao wairua. They told us of their whakamā in having to expose themselves to strangers without protection which all added to their feelings of vulnerability,” says Kendall.
She believes the success of the HPV self-testing programme is an indication of what can happen in health when you listen to the people you are trying to help. “During the RCT, women told us they felt they were winning with the self-test because they had an opportunity to do something for themselves on their terms. Importantly, they were also having conversations about health and recommending the self-test for their daughters, nieces, and nannies. We were having nannies who were having their first screens.”
Kendall says that there is a need for people to better understand HPV because it doesn’t just impact cervical cancer, HPV is also implicated in head and neck, anal, and penile cancers.
With the success of self-testing, Te Tātai Hauora o Hine researchers in partnership with the Cancer Society are committed to eliminating cervical cancer in New Zealand by 2038. “We have improved screening but now we need to improve the other pillars such as improving vaccination, diagnosis and treatment,” says Kendall.
“I really love that Te Tai Tokerau wāhine had such a massive impact on making self-screening a reality for other women around the motu. It shows that our wāhine Māori are unbelievable and know what is healthy and how to be well. Sometimes we must just get out of the way and make things happen on their terms.”