Time constraints prevent women from attending cervical screening; overcoming practical barriers may maximize screening

Some women struggle to fit cervical cancer screening into their busy lives, a new Cancer Research UK study has found.

While emotional barriers such as embarrassment were thought to be the main reason for not attending, this latest study in the Journal of Medical Screening suggests that practical difficulties may be more important.

In the study from scientists at Cancer Research UK's Health Behaviour Research Centre at University College London, interviews were carried out with 580 women, aged 26 to 64, in order to determine their cervical screening history, perceived barriers to screening, voting behaviour and demographic characteristics.

They found that 85 per cent of the women had accepted their last invitation to screening, while the remaining 15 per cent were overdue, including 2.6 per cent who had never been.

Twenty-nine per cent of respondents felt that embarrassment was a barrier to screening; 21 per cent said that they intended to go but didn't always get round to it straight away; 14 per cent cited fear of pain; and 12 per cent admitted that they were worried about what might be found.

Importantly, women who went for screening were just as likely to find it embarrassing as those who were overdue. But women who were overdue for screening were much more likely than those who had been to screening to say that they 'didn't always get round to it straight away'.

The researchers also found that women who were unlikely to vote in elections were typically more likely to be overdue for screening, even after their views on potential barriers and demographic factors had been taken into account.

This effect was particularly strong among women between the ages of 26 and 44.

Dr Jo Waller, co-author and senior research associate at Cancer Research UK, said: "With uptake of cervical screening in England still much lower than we'd like, these findings suggest that overcoming practical barriers may be the most important factor in maximising cervical screening uptake.

"These results are encouraging; in the past, it was thought that emotional factors such as concern about embarrassment and pain were the best predictors. Minimising practical difficulties is a more achievable goal."

Commenting on the link between voting and screening attendance, Dr Waller noted that both activities "require a degree of organisation", meaning that women who do not get around to voting because of time constraints "may also be unlikely to attend screening".

The researchers suggested that this issue may be overcome by introducing evening and weekend clinics so that women are more likely to fit an appointment around their work or childcare commitments.

Sarah Woolnough, head of policy at Cancer Research UK, commented: "This study gives us important insights into what stops women going for screening. We thought that embarrassment or fear was what stopped women going for smear tests. But this study found that another important reason is not being able to fit screening into their busy lives.

"We strongly support changes that make these tests more accessible for busy women, like GP surgeries and clinics staying open later to make it easier for women to get to their tests. Cervical screening saves lives, so it's important to get rid of any barriers that stop women making that crucial appointment."