A Fall-off in Cervical Screening Coverage of Younger Women in Developed Countries

Lancucki, Lesz; Fender, Murielle; Koukari, A; Lynge, Elsebeth; Mai, Verna; Mancini, Emanuela; Onysko, Jay; Ronco, Guglielmo; Törnberg, Sven; Vessey, Martin; Patnick, Julietta

doi:10.1258/jms.2010.010017

Cited by 52 publications

(45 citation statements)

References 2 publications

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“…2 Similar trends have been noted in other countries including Australia, Canada, Sweden, Denmark, France and Italy. 3 Because the incidence of cervical cancer is highest in women in their thirties, 4 nonattendance for screening in young women has the potential to lead to diagnosis at a later stage of cancer and to poorer outcomes.…”

Section: Introductionmentioning

confidence: 99%

Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study

Waller

Jackowska²,

Marlow

et al. 2011

BJOG

105

101

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Objectives To explore differences in barriers to attendance at cervical screening across age groups because coverage of the cervical screening programme in England has been falling, particularly among women in the youngest age group (25-29 years).Design A qualitative study.Setting A university in London.Sample Professionals working in the screening field (n = 12) and women of varying ages who had either never attended for cervical screening or did not attend regularly (n = 46). MethodsIn Study 1 we interviewed professionals to elicit their views on the reasons for lower screening attendance in young women. In Study 2, we carried out four focus groups (n = 27) and 19 individual interviews with under-screened women to explore their barriers to attendance. Verbatim transcripts were analysed using Framework Analysis.Results Reasons for nonattendance were many and varied. Health professionals identified population-level factors, service provision issues, time pressures, risk perceptions, lack of knowledge and psychological barriers. The nonattenders fell into two groups: those who had made an active decision not to take part (who tended to be older), and those who intended to be screened but did not attend (predominantly younger women). Practical barriers were raised more often by younger women whereas older women had more negative attitudes to screening.Conclusion This study provides rich data on the complex reasons why women do not attend for cervical screening. It points to age differences in barriers to screening, and suggests that addressing practical issues such as appointment systems and clinic times may have a positive impact on attendance in young women.

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Section: Introductionmentioning

confidence: 99%

Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study

Waller

Jackowska²,

Marlow

et al. 2011

BJOG

105

101

View full text Add to dashboard Cite

show abstract

“…Studies examining uptake in other national programmes demonstrate lower coverage in those most at risk. For example, in the cervical screening programme in England, data show a fall to two-thirds uptake of smears in women, aged 25–29 in the last five years, compared with 75% in 2001,9 when the highest incidence of cervical cancer is in women in their thirties10 and the average time for progression of severe precancerous lesions to invasive cervical cancer is estimated to be 10–15 years 11. Uptake of cervical screening is also consistently lower in areas of lower socioeconomic status 3.…”

Section: Introductionmentioning

confidence: 99%

Uptake of the HPV vaccination programme in England: a cross-sectional survey of young women attending sexual health services

et al. 2014

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“…However, cervical screening participation by young women was already gradually declining over the past decade in Australia and other countries. 11 There has been concern that the availability of the vaccine might exacerbate the decline in young women's cervical screening rates, given the potential for women to misunderstand the limitations of the vaccine. A Victorian population study showed that among young, unvaccinated women, only 62.5% realized that the vaccine could not be used to treat cervical cancer or abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Promoting cervical screening after introduction of the human papillomavirus vaccine: the effect of repeated mass media campaigns

et al. 2013

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Objectives In 2007, Australia implemented an ongoing, school-based human papillomavirus (HPV) vaccination programme for school-aged girls, and a catch-up programme for 18–26-year-old women that ran until the end of 2009. The availability of what is widely known as the ‘cervical cancer vaccine’ means there is the potential for women to believe, incorrectly, that they no longer require regular cervical screening, and this risk needs to be addressed. The current study aimed to assess the effect of three mass media campaigns to promote cervical screening on the rate of cervical screening tests in the Australian state of Victoria, after HPV vaccine became available. Methods Seasonal time series assessed the effect of media campaigns broadcast in 2007, 2009 and 2010 on the rate of weekly cervical screening tests in Victorian women from 2006 to 2010, stratified by time since last screening test. Results The 2007 and 2009 media campaigns significantly increased the number of cervical screening tests per week. The 2007 campaign had a significant impact on lapsed screeners (>36 months since last test), overdue screeners (28–36 months since last test), and women never previously screened. The 2009 campaign significantly increased screening tests for overdue screeners, and the 2010 media campaign was associated with a significant increase in screening tests for lapsed screeners. Conclusions A well-researched and carefully pretested television advertising campaign with accurate, actionable messages can elicit appropriate screening behaviour among some of the appropriate groups even in a changed environment of complex, and potentially competing, messages.

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A Fall-off in Cervical Screening Coverage of Younger Women in Developed Countries

Abstract: There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has been clearly identified and there is a need for further studies to investigate the possible reasons for this phenomenon.

Cited by 52 publications

References 2 publications

Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study

Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study

Uptake of the HPV vaccination programme in England: a cross-sectional survey of young women attending sexual health services

Promoting cervical screening after introduction of the human papillomavirus vaccine: the effect of repeated mass media campaigns

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