The behavioural aspects of breast and cervical screening

The clinical potential of any screening modality is unlikely to be realised unless a majority of the target group participates in the screening. Behavioural studies of screening observe a negative correlation with lower social class, income, education and with higher age. Education and persuasion programmes have increasingly been designed with these factors in mind. More recent studies, however, indicate that the way in which the screening service is made available to women affects their perceptions of it and, therefore, their participation at least as much as social factors; and properly designed presentation may even cancel out the effect of age and social class. This paper describes and discusses the studies which have led to the development of a consumer-oriented, service initiated (COSI) approach.