Reflections about attendance in the Norwegian cervical cancer screening program among the youngest invited women aged...

Understanding motivators for cervical cancer screening among young women is critical for improving participation rates and reducing the incidence of cervical cancer. Young women have low participation rates in the CervicalScreen Norway. In 2022, the first cohort of school-based human papilloma virus vaccinated women entered the screening programme at the age of 25 years. This paper investigates reflections regarding cervical cancer screening and factors that influence attendance among first or second-time invitees in the CervicalScreen Norway.

The study comprises 18 qualitative semi-structured individual interviews with Norwegian women aged 25-29 years of which 14 had attended screening. We used reflexive thematic analysis with a critical approach and identified three main themes related to trust, social expectations, and perceived vulnerability.

The three main themes were 'trusting health authorities but wishing for a clearer message'; 'normalisation of screening participation driven by social expectations'; and 'efforts to avoid vulnerability during the test procedure'. Trusting the authorities to provide beneficial health initiatives, the women would follow advice about screening. Social expectations led to consider screening participation as the right thing to do. These young women felt vulnerable and inexperienced with gynaecological examinations and opted for screeners that reduced their feeling of vulnerability.

Providing clear information on the screening procedure and expectations during gynaecological examinations is essential to reduce vulnerability and enhance participation among young women. Communication should highlight that screening is readily accessible in primary healthcare and be shared through media platforms popular with younger women.