Personal Influencing Factors Associated With Pap Smear Testing and Cervical Cancer

Ackerson, Kelly; Pohl, Joanne M.; Low, Lisa Kane

doi:10.1177/1527154408318097

Cited by 45 publications

(50 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Demographics and social support; inconvenient clinic hours, male providers, and insensitive staff; poor awareness of the indications and benefits of the cervical smear test; lack of knowledge of cervical cancer and its risk factors; fear of embarrassment, pain, or cancer; anxiety caused by receiving an abnormal cervical smear result, poor understanding of cervical screening procedures were among the factors influence a women's decision about cervical cancer screening (Fylan, 1998;Abercrombie, 2001;Ackerson et al, 2008;Cooper, 2011). Seow et al (1995) demonstrated that women's previous experience of Pap smears also influenced their intention to participate in screening programmes.…”

Section: Introductionmentioning

confidence: 99%

Promoting Attendance at Cervical Cancer Screening: Understanding the Relationship with Turkish Womens' Health Beliefs

Demirtaş¹,

Açıkgöz²

2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Promoting Attendance at Cervical Cancer Screening: Understanding the Relationship with Turkish Womens' Health Beliefs

Demirtaş¹,

Açıkgöz²

2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

“…The findings are, however, intuitive, in line with prior expectations and show clear preferences for the attributes of interventions designed to overcome the well-documented reasons for non-attendance at screening. 4,[61][62][63][64] An 'opt-out' question with the choice 'not to screen' was not included as part of the experimental design in the DCE survey. Cervical screening is an area where women can choose not to be screened, as was the case with the target population in this study.…”

Section: Levels Of Opinionsmentioning

confidence: 99%

A cluster randomised trial of strategies to increase cervical screening uptake at first invitation (STRATEGIC)

Kitchener

Gittins

Rivero‐Arias

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

BackgroundFalling participation by young women in cervical screening has been observed at a time that has seen an increase in the incidence of cervical cancer in the UK in women aged < 35 years. Various barriers to screening have been documented, including fear, embarrassment and inconvenience.ObjectivesTo measure the feasibility, clinical effectiveness and cost-effectiveness of a range of interventions to increase the uptake of cervical screening among young women.DesignA cluster randomised trial based on general practices performed in two phases.SettingPrimary care in Greater Manchester and the Grampian region in Scotland.ParticipantsPhase 1: 20,879 women receiving their first invitation for cervical screening. Phase 2: 10,126 women who had not attended by 6 months.InterventionsPhase 1: pre-invitation leaflet or not, and access to online booking (Manchester only). Phase 2: (1) vaginal self-sampling kits (SSKs) sent unrequested (n = 1141); or (2) offered on request (n = 1290); (3) provided with a timed appointment (n = 1629); (4) offered access to a nurse navigator (NN) (n = 1007); or (5) offered a choice between a NN or a SSK (n = 1277); and 3782 women in control practices.Main outcome measuresUplift in screening compared with control practices, cost-effectiveness of interventions, and the women’s preferences explored in a discrete choice experiment.ResultsThe pre-invitation leaflet and offer of online booking were ineffective when compared with control practices at 3 months, 18.8% versus 19.2% [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.88 to 1.06;p = 0.485] and 17.8% versus 17.2% (OR 1.02, 95% CI 0.87 to 1.20;p = 0.802), respectively. The uptake of screening at 3 months was higher among previously human papillomavirus (HPV)-vaccinated women than unvaccinated women, 23.7% versus 11% (OR 2.07, 95% CI 1.69 to 2.53;p < 0.001). Among non-attenders, the SSK sent intervention showed a statistically significant increase in uptake at 12 months post invitation, 21.3% versus 16.2% (OR 1.51, 95% CI 1.20 to 1.91;p = 0.001), as did timed appointments, 19.8% versus 16.2% (OR 1.41, 95% CI 1.14 to 1.74;p = 0.001). The offer of a NN, a SSK on request, and a choice between timed appointments and NN were ineffective. Overall, there was a gradual rather than prompt response, as demonstrated by uptake among control practices. A discrete choice experiment indicated that women invited who had not yet attended valued the attributes inherent in self-sampling. The health economic analysis showed that both timed appointments and unsolicited SSK sent were likely to be cost-effective at a cost per quality-adjusted life-year (QALY) gained of £7593 and £8434, respectively, if extended across the national 25-year-old cohort throughout the duration of screening. The certainty of these being cost-effective at a ceiling ratio of £20,000 per QALY gained was > 90%.ConclusionWomen receiving their initial screening invitation frequently delay taking up the offer and the net impact of interventions was small. Timed appointments and SSKs sent to non-attenders at 6 months are likely to be a cost-effective means of increasing uptake and should be considered further. HPV vaccination in the catch-up programme was associated with an increased uptake of cervical screening. Future work should focus on optimising self-sampling in terms of age range, timing of offer for non-attenders and use of urine testing instead of vaginal samples.Trial registrationCurrent Controlled Trials ISRCTN52303479.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 68. See the NIHR Journals Library website for further project information.

show abstract

“…The objective of the IMCHB is to identify and suggest explanations for relationships between these three major elements. The IMCHB has previously been used because its ecological components are appropriate for health disparity studies where socio-environmental factors are an important consideration (Ackerson K et al, 2008). Ackerson et al (2008) used the IMCHB to guide the analysis of women's perceptions about cervical cancer screening (Ackerson K et al, 2008).…”

Section: The Evolution Of Behaviour Change Theoriesmentioning

confidence: 99%

“…The IMCHB has previously been used because its ecological components are appropriate for health disparity studies where socio-environmental factors are an important consideration (Ackerson K et al, 2008). Ackerson et al (2008) used the IMCHB to guide the analysis of women's perceptions about cervical cancer screening (Ackerson K et al, 2008). The BMHSU includes four components: a contextual level, an individual level, health behaviour, and health outcomes (Andersen R, 2008;Andersen RM, 1995;Phillips KA et al, 1998).…”

Section: The Evolution Of Behaviour Change Theoriesmentioning

confidence: 99%

“…The Pap test identifies pre-cancerous cervical lesions that can be treated before the development of invasive cancer. Several analyses have found that approximately half of women diagnosed with invasive cervical cancer had not been screened in the previous five years or had never been screened (Ackerson K, Pohl J, & Low LK, 2008;Decker KM, McLachlin CM, Kan L, Rose J, Onysko J, Ahmad R, et al, 2011;Parboosingh EJ et al, 1996). Therefore, women who are not screened at the recommended interval or who have never been screened have a higher risk of developing cervical cancer and are more frequently diagnosed at an advanced stage (Decker KM, McLachlin CM, Kan L, Rose J, Onysko J, Ahmad R, et al, 2011;Health Canada, 2002;Woltman KJ & Newbold KB, 2007).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the Effectiveness of Cervical Cancer Screening Invitation Letters

Decker

Turner

Demers

et al. 2013

Journal of Women's Health

View full text Add to dashboard Cite

The purpose of this study was to evaluate the effectiveness of an invitation letter on cervical cancer screening participation among unscreened Manitoba women 30 to 69 years of age. A cluster randomized trial design was used in which unscreened women (n=31,452) were randomly assigned by the forward sortation area (FSA) of their postal code to an intervention group that was sent an invitation letter (n=17,068) or a control group that was not sent an invitation letter (n=14,384). In order to ensure access to screening, a Pap test clinic was held by a health centre in 20 of the 27 FSAs in the intervention group two to three weeks after the invitation letters were mailed.Six months after the letters were mailed, 1,010 women in the intervention group Using the Behavioural Model of Health Services Use as a theoretical framework, predisposing, enabling, and need factors that might influence screening participation were also included as covariables in multivariable logistic regression Generalized Estimating Equation (GEE) models. There was a significant main effect of age group (p<0.001), average household income (p=0.01), area of residence (p=0.01), residential mobility (p=0.05), and access (p=0.001). Interactions between the invitation letter and each iii significant variable were tested. The interaction between the invitation letter and age group remained significant (p=0.02); therefore, the effectiveness of the invitation letter was related to age.Of the 1,451 women who had a Pap test in the next six months, 21 women (1.45%) had a high-grade Pap test result. It is recommended that invitation letters continue to be sent to unscreened Manitoba women 30 to 69 years of age and that other provincial screening programs consider sending invitation letters to unscreened women.iv Acknowledgements

show abstract

Personal Influencing Factors Associated With Pap Smear Testing and Cervical Cancer

Cited by 45 publications

References 18 publications

Promoting Attendance at Cervical Cancer Screening: Understanding the Relationship with Turkish Womens' Health Beliefs

Promoting Attendance at Cervical Cancer Screening: Understanding the Relationship with Turkish Womens' Health Beliefs

A cluster randomised trial of strategies to increase cervical screening uptake at first invitation (STRATEGIC)

Evaluating the Effectiveness of Cervical Cancer Screening Invitation Letters

Contact Info

Product

Resources

About