What prevents women from taking cervical pap smear?

Background and purpose

The proportion of Norwegian women participating in the cervical cancer screening programme has fallen somewhat in recent years. High participation in the mass screening is associated with reduced incidence and mortality of cervical cancer, and more than half of those who are diagnosed with cervical cancer have not participated in cervical screening.

The project wants to find out why some women do not on a regular basis take a cervical pap smear. By examining individual characteristics of the women and doctors, we want to identify causes of low participation in cervical screening.

Findings

The study revealed that several socioeconomic reasons such as income, education and employment affect participation in cervical cancer screening in Norway. Having a male GP can prevent the woman from taking a cervical pap smear, especially if there is not a female doctor working at the same medical centre.

We also saw that immigrant women attend screening to a lesser extent, and that there are large inequalities in attendance based on country of birth and age. Attendance was often higher if the woman had lived in Norway ≥ 10 years. However, this did not apply to all immigrant groups.

The study has identified hitherto unknown causes that prevent attendance at cervical screening, The results are extremely important aspects of cervical screening, especially from a societal perspective, where Norway strive for equal health services for all.

In order to better provide health services to a multicultural society, these must be facilitated through interpretation services, and the provision of information in languages that different patient groups understand.

In this way, we can try to remove the reasons that prevent attendance, and thus reverse the trend that fewer and fewer women participate in cervical screening. 

Status

The project is now completed. The results have been presented at several international conferences. See the below publications from the project. 

Publications

Leinonen MK, Campbell S, Ursin G, Tropé A,    Nygård M (2017)
Barriers to cervical cancer screening faced by immigrants: a registry-based study of 1.4 million women in Norway
Eur J Public Health, 27 (5), 873-879
PubMed 28957477

Leinonen MK, Campbell S, Klungsøyr Ø, Lønnberg S, Hansen BT, Nygård M. Personal and provider level factors influence participation to cervical cancer screening: A retrospective register-based study of 1.3 million women in Norway. Prev Med. 2016. doi:http://dx.doi.org/10.1016/j.ypmed.2016.11.018