Cervical cancer risk can be significantly reduced through HPV vaccination and regular cervical screening. However, in Australia, 42% of eligible women did not screen in the 2012-2013 period (Australian Institute of Health and Welfare, 2015). Young women in particular have lower rates of screening, and there is evidence to suggest that young women's screening attendance is declining in developed countries (Lancucki et al., 2010).Despite this, there is a paucity of research addressing barriers and facilitators in young women that may explain this trend. Additionally, no study has explored the needs of women who have never screened.
Twenty women aged 25 – 35 were interviewed about their experiences of screening, and barriers and facilitators to screening attendance. Thematic analysis was used to compare and contrast interviews, locating common themes.
Barriers and facilitators to screening differed depending on whether women had attended screening before. Women’s first screening experience was dominated by emotional barriers, such as anxiety about an unfamiliar procedure and seeking emotional support from the practitioner carrying out the test. These were also barriers for women who had never screened. In contrast, for women who had already screened, the process of screening was normalised, and practical barriers such as lack of time and forgetting when to screen were more common. For women who had screened, it was convenient for them to screen during routine primary health care appointments, especially when health care providers reminded them that they were due to re-screen.
Education campaigns should be promoted differently depending on whether women have been screened previously. This includes education and communication with women by health professionals who are central to actively promoting cervical screening as a component of primary health care. Women who have not screened before require more emotional support, whereas other women rely on health care professionals for practical reminders to screen.
Australian Institute of Health and Welfare. (2015). Cervical screening in Australia 2012-2013 (Cancer series no. 93. Cat. no. CAN 91.). Canberra: AIHW. Retrieved from http://www.aihw.gov.au/publication-detail/?id=10737420251
Lancucki, L., Fender, M., Koukari, A., Lynge, E., Mai, V., Mancini, E., … Patnick, J. (2010). A fall-off in cervical screening coverage of younger women in developed countries. Journal of Medical Screening, 17(2), 91–96. http://doi.org/10.1258/jms.2010.010017