Age Criteria for Cervical Screening in England: Qualitative Study of Women’s Views

Abstract

The age criteria applied in the NHS Cervical Screening Programme have been much debated at policy and professional levels, but little is known about women’s views on appropriate age criteria. Our objective is to provide insight into women’s views on age criteria for the NHS Cervical Screening Programme in England. We present data collected as part of a qualitative interview study conducted in the East Midlands of England. Thirty-five women, representing a range of ages and ethnic groups, were interviewed. Analysis was based on the constant comparative method. Women’s views about the age criteria that should appropriately be applied to cervical cancer screening diverged considerably from the technical principles and criteria upon which policy decisions are based. Women called for screening to be extended at both the upper and the lower ends of the age range. However, there was little explicit acknowledgment in women’s accounts of the risks posed by screening or of the relative effectiveness and cost-effectiveness of screening in women of different ages. Policy decisions about screening programmes often face problems of legitimacy and acceptability. There is an increasingly pressing need to ensure that the criteria used to make decisions about who will be offered screening are made explicit and communicated effectively, so that people’s views can be well-informed.