EQUALSCREEN – INCREASED ATTENDANCE AND REDUSED INEQUITY IN CERVICAL CANCER SCREENING

To achieve more efficient cervical cancer prevention, it is important to remove barriers to screening attendance. In this research project, we will examine whether self-sampling can increase attendance to screening and improve cervical cancer prevention in Norway.

Published: 29.03.2019, updated: 30.09.2019

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.

 

Can self-sampling tests increase screening attendance?

In this study, we will 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 aim to assess whether self-sampling may reduce social inequity in screening attendance.

We will perform a randomized control trial (RCT), and compare 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 will be 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 will be referred to a gynaecologist whereas the other half will receive a follow-up appointment with their regular general practitioner (GP).

The self-sampling test will only be offered to women who are invited to participate in the study.The study on the use of cervical self-sampling will start in March 2019.

If you have received an invitation to order a self-sampling test, you can order it here.

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. 

Watch user guide video on the self-sampling test

 

What are the barriers to cervical cancer screening?

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

Aasbø G, Solbrække KN, Waller J, Tropé A, Nygård M, Hansen BT
Perspectives of non-attenders for cervical cancer screening in Norway: a qualitative focus group study
BMJ open 9(8), e029505 (2019)

 

Project affiliations

Cancer Registry of Norway

Bo Terning Hansen, Gunvor Aasbø, Ameli Tropé, Karina Undem and Mari Nygård.

 External affiliates

University College London: Jo Waller

University of Oslo: Kari Nyheim Solbrække

Albert Einstein College of Medicine: Philip Castle

University of Bergen: Tone Bjørge

Akershus University Hospital: Irene Kraus Christiansen

 

The project is financed by The Norwegian cancer Society and Thea Steens memorial fund.