EQUALSCREEN – Increased attendance and reduced inequity in cervical cancer screening
Background and aim
About one third of Norwegian women do not attend screening against cervical cancer as often as recommended by the Norwegian Cervical Cancer Screening Program (NCCSP). Minority women and women currently outside of the workforce are overrepresented among under-screened women. Thus, it is important to obtain more knowledge on how to overcome barriers to cervical cancer screening faced by under-screened women.
In this study, we examine whether a self-sampling Human Papillomavirus (HPV) test can increase attendance to cervical cancer screening among women who have not been screened for at least ten years. Furthermore, we assess whether self-sampling may reduce social inequity in screening attendance.
We have performed a randomized control trial (RCT), and compared the screening attendance among women who receive (i) the usual reminder from NCCSP to be screened, (ii) a self-sampling test in the mail, and (iii) an offer to order a self-sampling test. 6000 randomly selected women between the ages of 35 to 69 who have not been screened for cervical cancer for at least a decade was invited to participate in the study.
In addition, we assess the best follow-up method for women with a positive HPV test result. Half of the HPV-positive women are referred to a gynaecologist whereas the other half received a follow-up appointment with their regular general practitioner (GP).
It is no longer possible to order the self-sampling test as the recruitment to the study has been completed.
If you have any questions regarding the self-sampling test or the study, please contact us by mail to celleprove@kreftregisteret.no or by phone: 22928941/ 22928919.
Results
In the first part of the project we carried out a qualitative focus group study where we interviewed long-term non-attending women about their views on cervical cancer screening attendance.
The results from the study shows that women who are overdue for screening hesitate to book a screening appointment because “it is easy to forget about it”, “one have to arrange one’s own appointment”, “it has to be a must”, or “pelvic examination is a humiliating situation”. Thus, how women perceive the importance of cervical cancer screening depends on how they are encouraged by the screening programme and how cervical cancer screening is facilitated in the health care services.
Publications
Perspectives of non-attenders for cervical cancer screening in Norway: a qualitative focus group study
BMJ Open, 9 (8), e029505
DOI 10.1136/bmjopen-2019-029505, PubMed 31471438
