An Investigation into the Influence of Geographical Factors on Attendance for Cervical Cytology Screening

Abstract

The paper describes an empirical test of whether or not accessibility, mobility and time-space constraints, among a wider range of factors, are significant in discouraging women from making and attending appointments for cervical smears. A survey recorded the characteristics of 49 attending and 53 non-attending women resident in Salford. Binary logistic regression was used to identify those factors influential in discriminating between attenders and non-attenders. At best accessibility was only of marginal significance, and the weight of evidence suggested the unimportance of geographic mobility. Time-space constraints in the form of work commitments were insignificant, but other commitments and constraints, including illness, bereavement and holidays, were important reasons for non-attendance. The 35-59 age range of women interviewed meant that childcare commitments were largely irrelevant; indeed, childless women were overwhelmingly non-attenders. Further larger-scale studies should be pursued, including women of a wider age range and resident in non-conurbation environments, to clarify the importance of marginally significant variables like accessibility and gender of doctors, and to assess women's understanding of the need for, and function of, cervical smear tests.