In Australia, women with disabilities are under-screened for cervical cancer compared with Australians without a disability (Department of Health and Human Services 2013). Barriers include physical limitations, competing health needs that require more urgent medical attention, the trauma of undergoing an invasive test, and lack of information. Assumptions that all women with disabilities are not sexually active also need to be addressed.

Rape victims and survivors of previous sexual abuse may also need additional support, including issues around disclosure of past history of sexual abuse or trauma.

The following approaches are recommended to promote participation and improve the experience of cervical screening:

• Consider reasonable adjustments, including alternative pathways, such as self-collection.
• Consider informed consent and the potential barriers associated with obtaining this, particularly if a power of attorney lies with a family member or carer.
• Encourage women to bring a support person with them to appointments.
• For women with disabilities, encourage use of the Australian Institute of Health and Welfare disability flag at the point of admittance, and note any disabilities in referral forms to diagnostic assessment.
• Ensure facilities actively address the access requirements of people with disabilities.
• Consider catch-up HPV vaccination if appropriate.