Enhancing equity and efficiency in cervical screening uptake: a multidisciplinary quality improvement initiative.

Abstract

Cervical cancer screening is vital for early detection and prevention, yet uptake remains suboptimal in diverse communities. Cauldwell Medical Centre reported cervical screening uptake rates of 54% (ages 25-49) and 62% (ages 50-64) by June 2022, both significantly below the national target of 80%, with a concerning 8 percentage point disparity between age groups. Using quality improvement (QI) methodologies, including Plan-Do-Study-Act cycles and statistical process control charts, the team tested eight cycles of change grouped into three high-impact actions designed to improve accessibility, trust and personalisation of cervical screening services. Tests of change included culturally sensitive outreach, extended clinic hours and a self-booking system to enhance accessibility and engagement. This QI initiative achieved a marked reduction in age-related inequalities in cervical screening uptake. By the end of the intervention period (March 2023), screening rates increased from 54% to 69% among women aged 25-49 and from 62% to 72% among women aged 50-64, narrowing the gap from 8 to 3 percentage points-a 60% reduction in disparity. By the final monitoring week, uptake further increased to 73% (ages 25-49) and 82% (ages 50-64), demonstrating how structured QI approaches can amplify the effectiveness of existing healthcare processes. This project highlights that systematically applying QI methodologies can effectively address healthcare inequalities, providing a scalable model for improving cervical screening uptake among under-represented populations.