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      Cervical screening among migrant women: a qualitative study of Polish, Slovak and Romanian women in London, UK

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          Abstract

          Objective

          To explore awareness of and participation in cervical screening services in women from Poland, Slovakia and Romania living in London, UK.

          Methods

          Three qualitative studies were carried out in London in 2008–2009: an interview study of professionals working with Central and Eastern European migrants ( n=11); a focus group study including three Polish, one Slovak and one Romanian focus group; and an interview study of Polish ( n=11), Slovak ( n=7) and Romanian ( n=2) women.

          Results

          Awareness of the cervical screening programme was good, but understanding of the purpose of screening was sometimes limited. Some women were fully engaged with the UK screening programme; others used screening both in the UK and their countries of origin; and a third group only had screening in their home countries. Women welcomed the fact that screening is free and that reminders are sent, but some were concerned about the screening interval and the age of the first invitation.

          Conclusions

          Migrant women from Poland, Slovakia and Romania living in London vary in their level of participation in the National Health Service Cervical Screening Programme. More needs to be done to address concerns regarding screening services, and to ensure that language is not a barrier to participation.

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          Qualitative data analysis for applied policy research

          Jane Ritchie, Liz Spencer (1994)
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            Barriers to cervical cancer screening attendance in England: a population-based survey.

            Jo Waller, Marta Bartoszek, Jane Wardle … (2008)
            To explore barriers to cervical screening attendance in a population-based sample, and to compare barriers endorsed by women who were up-to-date with screening versus those who were overdue. We also tested the hypothesis that women who were overdue for screening would be more generally disillusioned with public services, as indexed by reported voting behaviour in elections. A population-based survey of women in England. Face-to-face interviews were carried out with 580 women aged 26-64 years, and recruited using stratified random probability sampling as part of an omnibus survey. Questions assessed self-reported cervical screening attendance, barriers to screening, voting behaviour and demographic characteristics. Eighty-five per cent of women were up-to-date with screening and 15% were overdue, including 2.6% who had never had a smear test. The most commonly endorsed barriers were embarrassment (29%), intending to go but not getting round to it (21%), fear of pain (14%) and worry about what the test might find (12%). Only four barriers showed significant independent associations with screening status: difficulty making an appointment, not getting round to going, not being sexually active and not trusting the test. We found support for our hypothesis that women who do not attend for screening are less likely to vote in elections, even when controlling for barrier endorsement and demographic factors. Practical barriers were more predictive of screening uptake than emotional factors such as embarrassment. This has clear implications for service provision and future interventions to increase uptake. The association between voting behaviour and screening uptake lends support to the hypothesis that falling screening coverage may be indicative of a broader phenomenon of disillusionment, and further research in this area is warranted.
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              The cervical cancer epidemic that screening has prevented in the UK.

              Julian Peto, Clare Gilham, Olivia Fletcher … (2004)
              Recent reports suggest that the reduction in mortality achieved by the UK national cervical screening programme is too small to justify its financial and psychosocial costs, except perhaps in a few high-risk women. We analysed trends in mortality before 1988, when the British national screening programme was launched, to estimate what future trends in cervical cancer mortality would have been without any screening. Cervical cancer mortality in England and Wales in women younger than 35 years rose three-fold from 1967 to 1987. By 1988, incidence in this age-range was among the highest in the world despite substantial opportunistic screening. Since national screening was started in 1988, this rising trend has been reversed. Cervical screening has prevented an epidemic that would have killed about one in 65 of all British women born since 1950 and culminated in about 6000 deaths per year in this country. However, these estimates are subject to substantial uncertainty, particularly in relation to the effects of oral contraceptives and changes in sexual behaviour. 80% or more of these deaths (up to 5000 deaths per year) are likely to be prevented by screening, which means that about 100000 (one in 80) of the 8 million British women born between 1951 and 1970 will be saved from premature death by the cervical screening programme at a cost per life saved of about pound 36000. The birth cohort trends also provide strong evidence that the death rate throughout life is substantially lower in women who were first screened when they were younger.
              Article 0 comments Cited 58 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Fam Plann Reprod Health Care
                Journal ID (iso-abbrev): J Fam Plann Reprod Health Care
                Journal ID (hwp): familyplanning
                Journal ID (publisher-id): jfp
                Title: The Journal of Family Planning and Reproductive Health Care
                Publisher: BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 1471-1893
                ISSN (Electronic): 2045-2098
                Publication date (Print): October 2012
                Publication date (Electronic): 4 January 2012
                Volume: 38
                Issue: 4
                Pages: 229-238
                Affiliations
                [1 ]PhD Student, Psychobiology Group, Department of Epidemiology and Public Health, University College London, London, UK
                [2 ]Senior Research Associate, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
                [3 ]Director, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
                [4 ]Research Assistant, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
                [5 ]Associate Research Professor, Trauma, Health & Hazards Center, University of Colorado, Colorado Springs, CO, USA and Warsaw School of Sciences and Humanities, Warsaw, Poland
                [6 ]Senior Research Associate, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
                Author notes
                [Correspondence to ] Dr Jo Waller, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK; j.waller@ 123456ucl.ac.uk
                Article
                Publisher ID: jfprhc-2011-100144
                DOI: 10.1136/jfprhc-2011-100144
                PMC ID: 3970719
                PubMed ID: 22219504
                SO-VID: 4901284b-371f-4caa-a5d5-c5c90797a0fd
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
                License:

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                Date received : 12 May 2011
                Date accepted : 16 November 2011
                Categories
                Subject: 1506
                Subject: Articles
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                ScienceOpen disciplines: Health & Social care
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                ScienceOpen disciplines: Health & Social care

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