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Non-attendance in a cervical cancer screening program: What happens if women’s requirements are met?
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Kalmar University.
2008 (English)In: Health Care for Women International, Vol. 29, no 2, 183-197 p.Article in journal (Refereed) Published
Abstract [en]

In this study we focus on women who have no registered cervical smear during the previous 5 years, their requirements for attendance, and promotive efforts performed. Of the 400 women randomly selected to answer a telephone-based questionnaire about future attendance at cervical cancer screening (CCS), 120 would consider having a cervical smear taken, and 50 of them wanted help to accomplish that. When meeting the women's requirements, such as being assured friendly treatment and a suitable appointment time, the numbers of registered cervical smears were higher for the study group compared with a control group. Still, the most highly resistant women did not attend.

Place, publisher, year, edition, pages
2008. Vol. 29, no 2, 183-197 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-12676DOI: 10.1080/07399330701738242OAI: oai:DiVA.org:liu-12676DiVA: diva2:16832
Available from: 2007-10-24 Created: 2007-10-24 Last updated: 2013-10-18
In thesis
1. Healthy women or risk patients?: Non-attendance in a cervical cancer screening program
Open this publication in new window or tab >>Healthy women or risk patients?: Non-attendance in a cervical cancer screening program
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Women afflicted with cervical cancer who have the highest morbidity and mortality rates have been the least likely to be screened. The overall aim of this research project was to investigate non-attendance in a cervical cancer screening (CCS) program among women with no registered cervical smear during the previous five years. Both quantitative (I,III) and qualitative methods (II) as well as costeffectiveness analysis (IV) were used in this research project. In Kalmar County women (aged 23-65 years) are invited to CCS every third year. All cervical smears taken both in opportunistic and organised CCS are coordinated in a register called Sympathy. The coverage is 88.4 %. From Sympathy, a random sample of 400 women served as a study group and another 400 women as a control group (III,IV). From the study group, 133 women participated in study I and 14 women in study II. Data was collected by telephone interviews based on a questionnaire (I), qualitative face-to-face interviews (II), questionnaire, promotive efforts and outcome (III), costs and effectiveness (IV). Quantitative data was analysed by descriptive and analytic statistics (I,III), qualitative data was analysed by content analysis. In study IV, cost-effectiveness analysis was used.

The women believed that CCS was a good idea for all other women, but tended to refer to various circumstances resulting in their own non-attendance. One of the most common reasons for non-attendance was the feeling of being healthy. The women prioritized family and work commitments, and the invitation to attend CCS was sometimes experienced as a stressful disturbance. The feeling of discomfort was related to the gynaecologic examination, or to health care visits in general (I,II). Of 133 women, 120 could consider having a cervical smear taken and their two most common requirements for doing so were to be assured they would be treated in a friendly way (19%) and to find a suitable time (18%) for having the cervical smear. Fifty women wanted to be helped to have a cervical smear taken. Promotive efforts ranged from making a simple telephone call to arranging an appointment time to a combination of promotive efforts including repeated encounters in order to create a trusting relationship with respect to taking the smear. In the study group, 29.5% (n=118) had a registered cervical smear at follow-up compared to 18.5% (n=74) in the control group, (p<0.001) (III). In the study group, the cost per cervical smear taken was 66.87 €, and in the control group it was 16.62 €. The incremental cost per additional cervical smear taken was 151.36 € (IV). In conclusion, women’s reasons for not attending CCS are complex and are influenced by both present and earlier circumstances. In settings with high coverage, further contact in order to promote women’s attendance at CCS seems to be associated with high costs in relation to the number of additional cervical smears taken.

Place, publisher, year, edition, pages
Institutionen för klinisk och experimentell medicin, 2007. 63 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1021
Keyword
Non-attendance, screening, cervical cancer, health promotion, improverment, informed consent
National Category
Clinical Science
Identifiers
urn:nbn:se:liu:diva-10092 (URN)978-91-85895-71-7 (ISBN)
Public defence
2007-11-09, Aulan, Hälsans hus, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Note
On the day of the defence data the status of article I was: In press; article II: Submitted; article II: Accepted and artile IV: In press.Available from: 2007-10-24 Created: 2007-10-24 Last updated: 2009-08-22

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Oscarsson, MarieWijma, Barbro

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Department of Clinical and Experimental MedicineFaculty of Health SciencesGender and medicineDepartment of Gynaecology and Obstetrics in Linköping
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