Exploring Older Women's Approaches to Cervical Cancer Screening

Guilfoyle, Sharon; Franco, Rebeca; Gorin, Sherri Sheinfeld

doi:10.1080/07399330701615358

Cited by 40 publications

(62 citation statements)

References 54 publications

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“…Several studies indicate that women believe that they would know if something was wrong and screening in the absence of symptoms is unnecessary (Guilfoyle et al, 2007;Savage & Clarke, 1998;Studts et al, 2013;Van Til et al, 2003;White 1995). This barrier may relate to a misperception of the purpose of screening with the focus being on detection rather than prevention of cervical cancer, as discussed earlier.…”

Section: Feeling Wellmentioning

confidence: 99%

“…In Studts et al's (2013) quantitative study the top barrier to cervical screening cited by Appalachian women aged 40-64 was that the test would make them worry. Fatalistic attitudes may also play a role with some older women stating that they would rather not know about cancer being present as they are going to die anyway (Guilfoyle et al, 2007;White, 1995). There may be a sense of not wanting to know too much and a temptation to 'stick your head in the sand' (White, 1995).…”

Section: Perceptions Of Cancermentioning

confidence: 99%

“…Qualitative research among women aged 46-59 suggests that older women recognise benefits in terms of detecting 'problems' early and link this to the advantage of potentially increasing life span (Savage & Clark, 1998). In some cases older women also mention the early detection of cancer itself (Guilfoyle et al, 2007).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Middle-aged and older women report feeling deterred from future screening attendance having had negative experiences or discomfort at previous appointments (White, 1995;Guilfoyle et al, 2007). Negative past experiences could relate to discomfort or pain or to physicians who may not have had time to conduct the examination in a sensitive manner (Van Til et al, 2003).…”

Section: Accepted Manuscript 10mentioning

confidence: 99%

“…Fear due to anticipated physical discomfort or pain may dissuade some older women from attending cervical screening (Armstrong 2007;Guilfoyle, Franco & Gorin, 2007;. In Armstrong's (2007) qualitative study of British women aged 20-64 past experiences of discomfort and difficulties the examiner had accessing the cervix were recalled.…”

Section: Fear or Discomfort And/or Painmentioning

confidence: 99%

See 4 more Smart Citations

Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence

Hope

Moss

Redman

et al. 2017

Preventive Medicine

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ACCEPTED MANUSCRIPT ABSTRACTCervical cancer is the fourth most common cancer in women worldwide (WHO, 2016). In many developed countries the incidence of cervical cancer has been significantly reduced by the introduction of organised screening programmes however, in the UK, a fall in screening coverage is becoming a cause for concern. Much research attention has been afforded to younger women but age stratified mortality and incidence data suggest that older women's screening attendance is also worthy of study. This paper provides a review of current evidence concerning the psycho-social influences that older women experience when Highlights There has been a lack of research on older women and cervical screening  This is at odds with age stratified incidence and mortality data  Embarrassment and logistical issues may deter older women from cervical screening  Psychological, emotional and physical age related changes can also play a role  Further research to enable informed decision-making among older women is required ACCEPTED MANUSCRIPT

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Section: Feeling Wellmentioning

confidence: 99%

Section: Perceptions Of Cancermentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscript 10mentioning

confidence: 99%

Section: Fear or Discomfort And/or Painmentioning

confidence: 99%

See 3 more Smart Citations

Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence

Hope

Moss

Redman

et al. 2017

Preventive Medicine

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Effect of Patient Characteristics on Uptake of Screening Using a Mailed Human Papillomavirus Self-sampling Kit

et al. 2022

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ImportanceMailing human papillomavirus (HPV) self-sampling kits increases cervical cancer screening participation, but effects may differ across subpopulations. Subpopulation data can inform US health care system implementation.ObjectiveTo identify patient characteristics that modify effectiveness of a mailed kit intervention at increasing screening.Design, Setting, and ParticipantsThis was a secondary analysis of data from the Home-Based Options to Make Cervical Cancer Screening Easy (HOME) randomized clinical trial conducted from 2014 to 2018 at Kaiser Permanente Washington. Data analysis was performed from March 2018 to May 2022. Individuals aged 30 to 64 years with female sex, health plan enrollment longer than 3 years and 5 months, a current primary care clinician, and no Papanicolaou test within the prior 3 years and 5 months were identified through electronic medical records and randomized (1:1) to the control or intervention group.InterventionsThe control group received usual care Papanicolaou screening reminders and outreach. The intervention group received usual care plus an unsolicited mailed HPV self-sampling kit.Main Outcomes and MeasuresScreening uptake was captured within 6 months after randomization. Baseline patient characteristics (age, race, ethnicity, travel time to clinic, income, body mass index, tobacco use, health plan enrollment duration, time since last Papanicolaou test, mammography, comorbidities, and colorectal cancer screening adherence) were extracted from the electronic medical record.ResultsOf 19 734 individuals (mean [SD] age, 50.1 [9.5] years; 14 129 [71.6%] White), 9843 were randomized to the intervention group, and 9891 were randomized to the control group. Screening uptake was 26.3% (2592 of 9843 individuals) in the intervention group vs 17.4% (1719 of 9891 individuals) in the control group (relative risk [RR], 1.51; 95% CI, 1.43-1.60). Although absolute differences in uptake by group varied little by screening history, relative effects were greater with longer vs shorter time since last Papanicolaou test (no prior Papanicolaou test: RRs, 1.85-3.25; ≥10 years: RR, 2.78; 5-10 years: RRs, 1.69-1.86; &lt;5 years: RRs 1.29-1.37). Relative effects were greater in participants overdue (RR, 2.03; 95% CI, 1.73-2.38) vs up-to-date with mammography (RR, 1.53; 95% CI, 1.41-1.67), although absolute difference was greater in the up-to-date group. Differences by age were not significant, with RRs of 1.33 to 1.48 across 5-year age groups in participants 30 to 54, vs 1.60 (95% CI, 1.40-1.82) in participants 55 to 59 and 1.77 (95% CI, 1.56-2.01) in participants 60 to 64 years. Among those mailed kits, there were differences in kit use vs in-clinic screening by age, race, plan enrollment duration, underscreening duration, and colorectal cancer screening adherence.Conclusions and RelevanceIn this secondary analysis of a randomized clinical trial, clinically important improvements in screening uptake were observed for all subgroups. Differences in magnitude of intervention effect and kit use highlighted opportunities to optimize HPV self-sampling for priority groups.Trial RegistrationClinicalTrials.gov Identifier: NCT02005510

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Cancer screening and aging: Research barriers and opportunities

Gorin

Gauthier

Hay

et al. 2008

Cancer

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Cancer is the second most common cause of death among those aged 65 years, and is a major cause of morbidity. There is some evidence that screening, by detecting precancerous lesions in asymptomatic patients, is effective in reducing cancer-related morbidity and mortality among older men and women. The objectives of the current review article were to identify some of the barriers to and opportunities for research in cancer screening among older individuals. Using expert opinion, the authors developed a taxonomy of barriers to research among those aged 65 years at 3 levels: the macro (policy and population), the organi-

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Exploring Older Women's Approaches to Cervical Cancer Screening

Cited by 40 publications

References 54 publications

Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence

Psycho-social influences upon older women's decision to attend cervical screening: A review of current evidence

Effect of Patient Characteristics on Uptake of Screening Using a Mailed Human Papillomavirus Self-sampling Kit

Cancer screening and aging: Research barriers and opportunities

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