Abstract
BackgroundYoung women’s attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising.ObjectivesWe assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening.DesignPostal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participantsNon‐attending young women in two UK regions.Main outcome measuresResponses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial.ResultsThe DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead.ConclusionsThe DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences.
Highlights
The reluctance of many to engage with the National Health Service (NHS) Cervical Screening Programme (CSP) is re‐ flected in national screening statistics
Screening uptake is known to be lower with increasing levels of deprivation, with uptake rates amongst young women shown to vary as much as 4% between highest and lowest deprivation categories.[8,9]
This paper presents previously unreported data on the stated pref‐ erences of a group of hard to reach young women for the character‐ istics of interventions, which could potentially be embedded within the NHS CSP to increase screening uptake
Summary
For a growing proportion of young women, embarrassment, anxi‐ ety, fear and inconvenience around testing are barriers to cervical screening.[1,2,3,4] The reluctance of many to engage with the National Health Service (NHS) Cervical Screening Programme (CSP) is re‐ flected in national screening statistics. Objectives: We assessed the preferences of non‐attending young women for alter‐ native ways of delivering cervical screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial. The STRATEGIC trial showed this same intervention to be most effective many women who received it and were screened, attended for conventional cytology instead. Conclusions: The DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
More From: Health expectations : an international journal of public participation in health care and health policy
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.