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Barriers to cervical cancer screening attendance in England: a population-based survey

Waller, J; Bartoszek, M; Marlow, L; Wardle, J; (2009) Barriers to cervical cancer screening attendance in England: a population-based survey. J MED SCREEN , 16 (4) 199 - 204. 10.1258/jms.2009.009073. Green open access

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Abstract

Objectives To explore barriers to cervical screening attendance in a population-based sample, and to compare barriers endorsed by women who were up-to-date with screening versus those who were overdue. We also tested the hypothesis that women who were overdue for screening would be more generally disillusioned with public services, as indexed by reported voting behaviour in elections.Setting A population-based survey of women in England.Methods Face-to-face interviews were carried out with 580 women aged 26-64 years, and recruited using stratified random probability sampling as part of an omnibus survey. Questions assessed self-reported cervical screening attendance, barriers to screening, voting behaviour and demographic characteristics.Results Eighty-five per cent of women were up-to-date with screening and 15% were overdue, including 2.6% who had never had a smear test. The most commonly endorsed barriers were embarrassment (29%), intending to go but not getting round to it (21%), fear of pain (14%) and worry about what the test might find (12%). Only four barriers showed significant independent associations with screening status: difficulty making an appointment, not getting round to going, not being sexually active and not trusting the test. We found support for our hypothesis that women who do not attend for screening are less likely to vote in elections, even when controlling for barrier endorsement and demographic factors.Conclusions Practical barriers were more predictive of screening uptake than emotional factors such as embarrassment. This has clear implications for service provision and future interventions to increase uptake. The association between voting behaviour and screening uptake lends support to the hypothesis that falling screening coverage may be indicative of a broader phenomenon of disillusionment, and further research in this area is warranted.

Type: Article
Title: Barriers to cervical cancer screening attendance in England: a population-based survey
Open access status: An open access version is available from UCL Discovery
DOI: 10.1258/jms.2009.009073
Publisher version: http://dx.doi.org/10.1258/jms.2009.009073
Additional information: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
Keywords: WOMEN, KNOWLEDGE, BRITAIN, PROGRAM, SAMPLE, SWEDEN, CHOOSE, WANT
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/113513
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