Increasing Screening Uptake for a Cervical Smear Test: Predictors of Attendance and the use of Action Plans in Prior Non-Attenders

Abstract National cervical screening programs have played a pivotal role in the prevention of cervical cancer. However, practices across the UK have reached an all-time low in cervical screening uptake. This study aimed to assess the efficacy of implementing an automated voice message reminder within the local general practice (GP) telephone triage system and explore the reasons which deter eligible patients away from cervical screening. A 20-second voice-message reminder in the telephone queue was played, addressing key risk factors along with a message from a child who lost his mother to cervical cancer. From the anonymised GP database, weekly new smear test bookings were monitored from 4 weeks prior until 2 weeks after the intervention was implemented. To qualitatively assess factors which deter patients away from screening, female patients were randomly sampled to fill in an anonymous questionnaire. The use of a low-cost 20 second voice message in the telephone queue across UK GP practices could be an effective method to increase cervical smear test coverage towards the national target of 80%. 35 questionnaire responses were received, main themes reported for not attending screening include embarrassment(37%), busy schedule(32%) and cultural differences(24%). In the week following the intervention, cervical smear tests increased more than 2-fold, from an average of 12 to 26 smears per week. This could be partly due to the convenient timing of voice recording, reminding them to book both appointments simultaneously and the child’s emotive message.

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Increasing screening uptake amongst those intending to be screened: the use of action plans

Patient Education and Counseling ◽

10.1016/j.pec.2003.09.005 ◽

2004 ◽

Vol 55 (2) ◽

pp. 218-222 ◽

Cited By ~ 27

Author(s):

Susan Michie ◽

Elizabeth Dormandy ◽

Theresa M. Marteau

Keyword(s):

Action Plans ◽

Screening Uptake

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Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys

BMJ Open ◽

10.1136/bmjopen-2017-016941 ◽

2017 ◽

Vol 7 (12) ◽

pp. e016941 ◽

Cited By ~ 12

Author(s):

David Mark Kelly ◽

Carla Estaquio ◽

Christophe Léon ◽

Pierre Arwidson ◽

Hermann Nabi

Keyword(s):

Colorectal Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Colorectal Cancer Screening ◽

Socioeconomic Inequalities ◽

Secondary Outcome ◽

Participation Rates ◽

Cervical Smear ◽

Screening Uptake

ObjectivesCancer screening is a form of secondary prevention for a disease which is now the leading cause of death in France. Various socioeconomic indicators have been identified as potential factors for disparities in breast, cervical and colorectal cancer screening uptake. We aimed to identify the socioeconomic inequalities, which persisted in screening uptake for these cancers, and to quantify these disparities over a 5-year period.SettingThe Cancer Barometer was a population-based-survey carried out in 2005 and 2010 in France.ParticipantsA randomly selected sample of participants aged 15–85 years (n=3820 in 2005 and n=3727 in 2010) were interviewed on their participation in breast, cervical and colorectal cancer screening-programmes and their socioeconomic profile.Primary and secondary outcome measuresFor each type of screening programme, we calculated participation rates, OR and relative inequality indices (RII) for participation, derived from logistic regression of the following socioeconomic variables: income, education, occupation, employment and health insurance. Changes in participation between 2005 and 2010 were then analysed.ResultsParticipation rates for breast and colorectal screening increased significantly among the majority of socioeconomic categories, whereas for cervical cancer screening there were no significant changes between 2005 and 2010. RIIs for income remained significant for cervical smear in 2005 (RII=0.25, 95% CI 0.13 to 0.48) and in 2010 (RII=0.31, 95% CI 0.15 to 0.64). RIIs for education in mammography (RII=0.43, 95% CI 0.19 to 0.98) and cervical smear (RII=0.36, 95% CI 0.21 to 0.64) were significant in 2005 and remained significant for cervical smear (RII=0.40, 95% CI 0.22 to 0.74) in 2010.ConclusionsThere was a persistence of socioeconomic inequalities in the uptake of opportunistic cervical cancer screening. Conversely, organised screening programmes for breast and colorectal cancer saw a reduction in relative socioeconomic inequalities, even though the results were not statistically significant. The findings suggest that organised cancer screening programmes may have the potential to reduce socioeconomic disparities in participation.

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Women Hearing Men: The Cervical Smear Test and the Social Construction of Sexuality

Sex, Sensibility and the Gendered Body ◽

10.1007/978-1-349-24536-9_7 ◽

1996 ◽

pp. 120-135 ◽

Cited By ~ 1

Author(s):

Linda McKie

Keyword(s):

Social Construction ◽

Cervical Smear ◽

Smear Test ◽

The Social

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Long term follow up of women with borderline cervical smear test results: Effects of age and viral infection on progression to high grade dyskaryosis

International Journal of Gynecology & Obstetrics ◽

10.1016/0020-7292(92)90278-q ◽

1992 ◽

Vol 39 (4) ◽

pp. 358-359

Author(s):

L. Hirschowitz ◽

A.E. Raffle ◽

E.F.D. Mackenzie ◽

A.O. Hughes

Keyword(s):

Viral Infection ◽

High Grade ◽

Test Results ◽

Cervical Smear ◽

Smear Test ◽

Long Term Follow Up

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A review of the literature: interventions to maximize capacity to consent and reduce anxiety of women with learning disabilities preparing for a cervical smear test

Health Services Management Research ◽

10.1258/095148402320176756 ◽

2002 ◽

Vol 15 (3) ◽

pp. 173-185 ◽

Cited By ~ 9

Author(s):

Sallyanne Broughton

Keyword(s):

Learning Disabilities ◽

Learning Disability ◽

Cervical Screening ◽

Complex Nature ◽

Relaxation Techniques ◽

Cervical Smear ◽

Capacity To Consent ◽

Smear Test ◽

Key Issues ◽

Screening Services

Due to the complex nature of the cervical screening for women with learning disabilities, this literature review has several different strands. The aim of which is to give a general overview of the literature available about women with learning disabilities and cervical screening. Discussing key issues in relation to uptake, access and risk factors associated with cervical screening. The role of the learning disability nurse in supporting access to cervical screening services within primary care will be explored. The notion that anxiety and a woman's capacity to consent impacts on her accessing cervical screening services and ultimately undergoing a cervical smear test, will be examined. Relaxation techniques with regard to ascertaining which techniques are more effective when used with individuals with a learning disability will also be discussed.

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