Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study

Area of Science:

• Public Health
• Gynecologic Oncology
• Health Services Research

Background:

• Cervical screening program coverage in England is declining.
• Coverage is particularly low among women aged 25-29 years.
• Understanding age-specific barriers is crucial for improving screening rates.

Purpose of the Study:

• To investigate age-related differences in barriers to cervical screening attendance.
• To identify factors contributing to low screening uptake in younger women.

Main Methods:

• Qualitative study involving interviews with screening professionals (n=12) and under-screened women (n=46).
• Focus groups and individual interviews explored barriers to attendance.
• Framework Analysis was used to analyze verbatim transcripts.

Main Results:

• Non-attendance reasons varied, including service provision, time pressures, risk perception, knowledge gaps, and psychological factors.
• Younger women predominantly cited practical barriers, while older women expressed more negative attitudes.
• Two nonattender groups emerged: older women with active decisions against screening and younger women intending but not attending.

Conclusions:

• Significant age differences exist in barriers to cervical screening.
• Practical issues like appointment systems and clinic scheduling are key barriers for younger women.
• Targeted interventions addressing practical barriers may enhance screening attendance in younger populations.