Understanding motivations for attending screening, by Jo Waller, Laura Marlow and Mairead Ryan

Updated: Sep 10, 2018


While Laurence has been making fantastic progress with his epic walk, here at University College London we’ve been continuing with our work to try and understand why increasing numbers of women are not participating in cervical screening. So here’s an update on what we’ve been doing.


We’ve published a new paper in the journal Psychoonology which describes an interview study we did last year. We spoke to 29 women, most of whom were not regular screening attenders, to try and understand more about their decision-making. We found that the reasons for non-attendance were different, depending on whether women just didn’t know much about screening, had made an active decision not to attend, or were planning to go for screening but hadn’t got round to it. You can read our blog about the study here.


We’ve been trying to understand more about why older women in particular sometimes chose not to go for screening. We know that some older women don’t see themselves as being at risk of cervical cancer because they’re either not sexually active, or are in a long-term relationship (so they don’t think they’re at risk of HPV). We’ve been testing whether giving women more information about how cervical cancer develops might shift their risk perceptions and make them more inclined to be screened. In an online experimental survey, we’ve randomised women to read different pieces of information about HPV, its relationship with cervical cancer, and the long timeline between picking up the virus and cancer developing. We’re currently analysing the data and hope to have some results soon.


We’ve also been exploring women’s preferences for booking their cervical screening appointments. We know that women sometimes find it difficult to get through to their GP surgery and book a convenient appointment, and may just give up if it seems like too much effort. By making the booking process easier, we may be able to increase participation. We surveyed just over 600 women about the way they’d like to be invited for screening (e.g. by letter, text message or email), the barriers they experienced to booking an appointment, and whether they’d prefer to book in a different way (e.g. online or using a mobile phone app rather than having to call). The results will be ready soon, and we hope they’ll inform policy in the screening programme.


Finally, we’ve been working with the UCLH Cancer Collaborative to do a service evaluation of offering a mobile phone app to book screening appointments. Three GP practices in Tower Hamlets have been sending text messages to women who are overdue for screening, including a link where they can download an app to use for booking their appointment. If the approach looks promising, we hope to evaluate its impact on screening uptake in a larger trial.


Cancer Research UK
In aid of:

Cancer Research UK is a registered charity in England and Wales (1089464), Scotland (SC041666) and the Isle of Man (1103). A company limited by guarantee. Registered company in England and Wales (4325234) and the Isle of Man (5713F). Registered address: Angel Building, 407 St John Street, London EC1V 4AD.

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