Understanding the Barriers to Cervical Cancer Screening among Older Women

Abstract

Despite the fact that 90% of cervical cancers can be prevented by regular Pap screening, many women are not screened regularly, particularly older women. To understand better the barriers to screening, the authors held five focus groups during April 2000 in Prince Edward Island (PEI), Canada. Of the 32% of women aged 45 to 70 who had not been screened over a 5-year period (1995-2000), 60 randomly selected women participated in this research. The authors analyzed discussions for themes using an inductive approach, with interpretation guided by the population health model. Women who have avoided a Pap test are falling between the cracks created by a complex interaction between personal experiences and the health system's approach to Pap screening.

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

“…Embarrassment when requesting an appointment and anxiety prior to screening can be severe (Van Til et al, 2003;Armstrong, 2007). Experiences during cervical screening range from feeling exposed or vulnerable to, in more extreme cases, molested or violated as reported in Van Til et al,'s Waller et al, (2009) found that although embarrassment was the top-cited barrier to screening attendance it did not predict self-reported attendance.…”

“…Qualitative studies support the presence of a misperception around the purpose of screening (Van Til et al, 2003;White, 1995 Older women were found to have significantly lower knowledge levels. However, others…”

“…The purpose of cervical screening may be misunderstood among older women as a method of detecting rather than preventing cancer (Pitts & Clarke, 2002;Van Til, MacQuarrie & Herbert, 2003;Waller, Yasemin, Wardle & von Wagner, 2015;Walsh 2006;White, 1995). Waller et al (2015) reported that of over 500 UK women aged 50-64, 72% thought that screening was to detect rather than prevent cancer.…”

“…Embarrassment and perceived indignity are often cited by older women as important barriers to screening (Armstrong, 2007;Van Til et al, 2003;Waller, Bartoszek, Marlow & Wardle, 2009;Waller, Jackowska, Marlow & Wardle, 2012;White, 1995). Embarrassment when requesting an appointment and anxiety prior to screening can be severe (Van Til et al, 2003;Armstrong, 2007).…”

“…Having a male screener has been identified in numerous studies as a barrier to older women's attendance (Savage & Clarke, 1998;Studts, Tarasenko & Schoenburg, 2013;Van Til et al, 2003;Walsh 2006). In the UK patients are given the option to request a female nurse to conduct the screening test.…”