7 November 2009
Women who don't vote are less likely to attend cervical cancer screening
In the first study to test the theory that low cervical screening uptake is associated with broader social disillusionment, a paper in the Journal of Medical Screening1 has shown that women who said they rarely or never voted in elections were more likely to be overdue for screening. The effect is also stronger among younger women between the ages of 26 to 44.
Emotional barriers such as embarrassment have often been found to be the most important obstacles to screening attendance. However, contrary to other studies2, this research shows that practical obstacles such as 'not getting round to it' and difficulty in arranging a convenient appointment, are more predictive of uptake than emotional barriers.
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.
"In terms of the correlation between voting and screening attendance, it may be that as both activities require a degree of organisation, women who do not manage to vote because of busy lives may also be unlikely to attend screening."
The authors call for further research to explore this association, to gain a better understanding of what social disillusionment really means.
The study, funded by Cancer Research UK, suggests that interventions to minimise practical difficulties such as evening and weekend clinics allowing women with work and/or childcare commitments to attend screening at a time convenient for them, may be beneficial.
In another paper3 from the same issue of the Journal of Medical Screening, a US study suggests that the more children living in a household, the lower the cancer screening attendance in adults from that household. The authors suggest that parents may have less time to get screened, and prioritise the needs of their children above their own.
1 Waller J. Bartoszek M, Marlow L and Wardle J. Barriers to cervical cancer screening attendance in England: a population-based survey. J Med Screen 2009;16:199-204
The Journal of Medical Screening is published by Royal Society of Medicine Press on behalf of the Medical Screening Society
2 Oscarsson MG, Benzein EG, Wijma BE. Reasons for non-attendance at cervical screening as reported by non-attendees in Sweden. J Psychosom Obstet Gynaecol 2008;29:23–31 McKie L.Women's views of the cervical smear test: implications for nursing practice – women who have not had a smear test. J Adv Nurs 1993;18:972–9
Dr Jo Waller, Senior Research Associate at the Cancer Research UK Health Behaviour Research Centre at UCL is available for interview.