Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women

Hansen, Bo T.; Hukkelberg, Silje S.; Haldorsen, Tor; Eriksen, Tormod; Skare, Gry B.; Nygård, Mari
January 2011
BMC Public Health;2011, Vol. 11 Issue 1, p264
Academic Journal
Background: Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods: The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression. Results: Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models. Conclusions: The likelihood of attendance in an organized screening program was higher among women who were aware of cervical screening, which suggests a potential for a higher attendance rate through improving the public knowledge of screening. Further, the lower awareness among opportunistic than reminded attendees suggests that physicians may inform their patients better when smears are taken at the physician's initiative.


Related Articles

  • The German Cervical Cancer Screening Model: development and validation of a decision-analytic model for cervical cancer screening in Germany. Siebert, Uwe; Sroczynski, Gaby; Hillemanns, Peter; Engel, Jutta; Stabenow, Roland; Stegmaier, Christa; Voigt, Kerstin; Gibis, Bernhard; Hölzel, Dieter; Goldie, Sue J. // European Journal of Public Health;Apr2006, Vol. 16 Issue 2, p193 

    We sought to develop and validate a decision-analytic model for the natural history of cervical cancer for the German health care context and to apply it to cervical cancer screening. Methods: We developed a Markov model for the natural history of cervical cancer and cervical cancer screening in...

  • Cervical Cancer: What Should We Tell Women About Screening? Tiffen, Jennifer; Mahon, Suzanne M. // Clinical Journal of Oncology Nursing;Aug2006, Vol. 10 Issue 4, p527 

    Cervical cancer is the second most common cancer among women worldwide, with significantly higher rates in developing areas, especially in Africa, the Caribbean, and Latin America (Parkin, Bray, Ferlay, & Pisani, 2005). In contrast, incidence and mortality rates of cervical cancer in the United...

  • Screening for cervical cancer: when theory meets reality. Nygård, Mari // BMC Cancer;2011, Vol. 11 Issue 1, p240 

    Cervical cancer screening reduces morbidity and mortality due to cervical cancer. However, there are many factors that determine the success of any cervical cancer prevention effort: the prevalence of human papillomavirus infection in general population, the existence of an organized screening...

  • Screening for cervical cancer in Jamaica. Fletcher, Horace // Caribbean Health;Apr1999, Vol. 2 Issue 1, p9 

    The article provides information on cervical cancer screening programmes in Jamaica. According to the article, carcinoma of the cervix is considered a very common cancer in the country, where it consists for about 27.5% per 100,000 of women's population. In addition, it mentions cites how...

  • Alternative sampling methods for cervical cancer screening: practical perspectives from the laboratory. Richter, K. L. // Southern African Journal of Gynaecological Oncology;2013, Vol. 5 Issue 2 Supplement, pS5 

    The coverage of cervical cancer screening in South Africa is inadequate, with an estimated 8.8-million unscreened women who are mainly serviced by the public health sector in lower-resourced areas. Alternative screening options need to be considered. Every step in the screening process needs to...

  • Experts to review evidence on cervical screening age.  // Practice Nurse;3/27/2009, Vol. 37 Issue 6, p7 

    The article reports on a review of evidence on whether women under the age of 25 should be routinely screened for cervical cancer which will be conducted by the independent Advisory Committee on Cervical Screening. the review will examine the harms and benefits that are associated with cervical...

  • Cervical cancer screening in urban clinics in eThekwini municipal area. Pillay, P.; Knight, S. E.; Rmaih, W. N. S. // Southern African Journal of Epidemiology & Infection;2009, Vol. 24 Issue 2, p18 

    Cancer of the cervix is a significant burden on women's health throughout the world despite it being a largely preventable disease. In South Africa, the launch of the National Guideline on Cervical Cancer Screening in 2000 aimed to reduce the incidence of cervical cancer in the country. The aim...

  • Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study. Davey, Elizabeth; d'Assuncao, Jefferson; Irwig, Les; Macaskill, Petra; Chan, Siew F.; Richards, Adele; Farnsworth, Annabelle // BMJ: British Medical Journal (International Edition);7/7/2007, Vol. 335 Issue 7609, p31 

    Objective To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. Design Prospective study. Setting Pathology laboratory in Sydney, Australia. Participants 55 164 split sample pairs (liquid based sample collected...

  • Human papillomavirus DNA testing on self-collected vaginal tampon samples as a cervical cancer screening test in a Gauteng population. Mnisi, E. F.; Dreyer, G.; Richter, K. L.; Horton, A.; Snyman, L. C. // Southern African Journal of Gynaecological Oncology;2013, Vol. 5 Issue 2 Supplement, pS15 

    Background: There is a need to simplify cervical cancer screening to reach more women. Tampon-collected specimens can be tested using molecular methods, but this type of self-screening has not been properly evaluated as a screening method in South Africa before. The objective of this study was...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics