Abstract
ObjectiveAs uptake of cervical screening continues to decline, this systematic review synthesises the qualitative literature on women's perceptions and experiences of cervical screening in the context of an organised call–recall programme, in order to understand the barriers to informed uptake.MethodsWe searched nine databases for English language peer‐reviewed publications reporting on qualitative data from screening‐eligible women, exploring barriers to cervical screening in countries that offer a nationally organised call–recall programme. Evidence was integrated using thematic synthesis.ResultsThirty‐nine papers from the UK, Australia, Sweden and Korea were included. The majority of participants had attended screening at least once. Two broad themes were identified: (a) should I go for screening? and (b) screening is a big deal. In considering whether to attend, women discussed the personal relevance and value of screening. Women who had previously attended described how it was a big deal, physically and emotionally, and the varied threats that screening presents. Practical barriers affected whether women translated screening intentions into action.ConclusionsThe variation in women's understanding and perceptions of cervical screening suggests that interventions tailored to decisional stage may be of value in increasing engagement with the invitation and uptake of screening in those who wish to take part. There is also a need for further research with women who have never attended screening, especially those who remain unaware or unengaged, as their perspectives are lacking in the existing literature. © 2016 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.
Highlights
In recent decades, many countries have had great success in reducing cervical cancer incidence and mortality through offering population-based screening programmes, using centralised registers of eligible women to generate invitations at regular intervals
Thirty-nine articles were included in the final synthesis (Supporting Information 4)
Through synthesising the qualitative research on women’s perceptions and experiences of cervical screening, we identified two novel overarching themes; the first, ‘should I go for screening?’, is indicative of women who are undecided about attending screening, after the first invitation and on subsequent occasions, as they consider both the relevance and the value of screening
Summary
Many countries have had great success in reducing cervical cancer incidence and mortality through offering population-based screening programmes, using centralised registers of eligible women to generate invitations at regular intervals. The national screening programme in the UK has averted an estimated 100 000 deaths from cervical cancer since its inception in 1988 [1]. Such systems remove the need for women to remember that they need screening and provide details of how to go about it. There are still many women invited to participate who do not attend according to recommendations, and in recent years, coverage of many programmes has been suboptimal. Heterogeneity exists in coverage by ethnic and socioeconomic group, with lower attendance in Black and Asian minority ethnic (BAME) groups [3] and women from socioeconomically deprived backgrounds [4,5]
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