'Pain and discomfort' putting off women attending cervical screening, Leeds study reports

A new study funded by Yorkshire Cancer Research and led by researchers at the University of Leeds aimed to identify the key factors that influence participation in the national cervical screening programme.

Along with ‘pain and discomfort’, other top reasons for putting off screening were ‘lack of time’ and ‘embarrassment’, while around a third of the women who responded said ‘difficulty making an appointment’ and ‘finding childcare’ prevented them from attending.

However, the study found that most women who experience barriers continue to attend screening and the researchers concluded that focusing on factors that encourage screening could improve participation.

A total of 194 women aged between 25 and 64 took part in the online survey, which asked participants to list barriers to attending screening and the factors that encouraged them to go.

When asked about the things that might encourage them to go for screening, one in three women taking part in the study said ‘ease of making appointments’, including being able to make appointments at alternative locations, would help them take part.

‘Peace of mind’ from a clear result, and the knowledge that screening can be lifesaving if cancer is found at an early stage, were also listed as the most common reasons to attend.

Research fellow and lead author of the study, lead author Dr Sarah Wilding, from the School of Psychology, University of Leeds, said: “This study confirmed that factors which encourage screening are key to the decision of whether to attend screening.

"Women suggested several improvements that might make attending easier or improve uptake, including making appointments via text or online and screening being carried out in mobile screening vans or clinics that can be accessed easily around work hours and childcare arrangements.

"Public health interventions should therefore focus on the factors that facilitate screening and how these interplay with barriers in order to improve uptake.”

Women aged 25 to 49 are invited to take part in cervical screening every three years, while women aged 50 to 64 are invited every five years.

In Yorkshire, a quarter of women do not take part when invited.

Screening

Cervical screening involves taking a sample of cells from the cervix which is then checked for certain types of human papillomavirus (HPV). Some strains of HPV can cause abnormal changes to cells, which, if not treated, can turn into cancer.

Yorkshire Cancer Research funds research across Yorkshire to improve participation in screening, from testing psychological methods to speaking to people in their preferred language.

According to Cancer Research UK, there are around 3,200 new cases of cervical cancer a year.

A report by Yorkshire Cancer Research, published in December 2019 showed that 263 women in Yorkshire were diagnosed with cervical cancer in 2017 - with 67 cases proving to be fatal.

In Yorkshire, 29 per cent of cervical cancer patients were diagnosed via screening, slightly higher than the England percentage.

In 2018/19, the most recent screening figures available, Yorkshire had a screening coverage that is slightly higher than the England average (74.8 per cent compared to 72.6 per cent).

The only Clinical Commisioning Group (CCG) in Yorkshire which had significantly lower screening coverage than the England average iwa NHS Bradford City at 61.4 per cent.

The CCG with the highest average coverage in Yorkshire was NHS Hambleton, Richmondshire and Whitby CCG at 79.8 per cent - significantly higher than England.

The coverage rates in GP practices varied greatly, ranging from 90.9 per cent in a practice in NHS East Riding of Yorkshire CCG, to 23.2 per cent in a practice in NHS Leeds CCG.