What do young women below national screening age in England think about cervical cancer and cervical screening? A qualitative study

Women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process

AIM

To explore Danish women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process.

DESIGN

A qualitative study using semi-structured, individual interviews with a phenomenological-hermeneutic approach.

METHODS

Interviews were conducted with 13 women with experience in opting out of cervical cancer screening. Women were recruited through a public flyer and interviewed virtually or by phone. The interviews were analysed using the theory of interpretation from Paul Ricoeur and consisted of three levels: naïve reading, structural analysis, and critical discussion and analysis. The present study adheres to the COREQ guidelines.

RESULTS

The women experience various personal causes for opting out of cervical cancer screening, such as low accessibility of screening appointments, discomfort during the smear test, fear of being sick, and insufficient information about the relevance of screening to the individual woman. The perceived disadvantages of screening outweighed their perceived advantages. The women's experiences did not include the role of the nurse in the procedures and knowledge sharing related to cervical cancer screening. However, nurses were described as having good communicative and relational qualifications relevant to being involved in cervical cancer screening.

CONCLUSION

It was challenging for the women to weigh the advantages and disadvantages of cervical cancer screening and thus to make an informed decision about participation. They expressed a need for more information on which to base their decision. This places nurses in a much needed, yet unexplored, role of identifying and lowering potential personal barriers that may outweigh the women's perceived benefits of participating in screening.

IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE

Nurses should play a more active role in cervical cancer screening such as improving general knowledge and facilitating two-way communication about its relevance.

REPORTING METHOD

The present study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Factors associated with cervical screening coverage: a longitudinal analysis of English general practices from 2013 to 2022

BACKGROUND

Cervical cancer remains an important global public health concern. Understanding the factors contributing to a decline in screening uptake in high-income countries is fundamental to improving screening rates. We aimed to identify general practice and patient characteristics related to cervical screening coverage in England between 2013 and 2022.

METHODS

We analyzed a panel of 59 271 General Practice (GP)-years from 7881 GP practices. We applied correlated random effects regression to examine the association between cervical screening uptake and a rich set of GP practice workforce, size, quality and patient characteristics.

RESULTS

Our results show a decline in overall screening rates from 2013/14 to 2021/22 from 77% to 72%. We find GP workforce and list size characteristics are strongly related to screening rates. An increase in 1 FTE Nurse per 1000 patients is related to a 1.94 percentage point increase in cervical screening rates. GP practices located in more deprived areas have lower screening rates.

CONCLUSIONS

GP workforce and patient characteristics need to be considered by decision-makers to increase screening rates. The implementation of self-sampling screening methods could help address some of the current barriers to screening, including lack of healthcare staff and facilities.

Sexual Behaviors and Intimate Relationships of Sexual Partners of Young Patients with Early-Stage Cervical Cancer: A Qualitative Study

Purpose

This study aimed to explore the sexual behaviors and intimate relationships of sexual partners of young patients with cervical cancer.

Patients and Methods

This study employed a descriptive phenomenological research design, which falls within the realm of qualitative research methods. Qualitative research typically utilizes interview techniques for gathering participants' experiences, perceptions, and behaviors. This study conduct face-to-face semi-structured interviews with the sexual partners of 15 young cervical cancer patients receiving cancer treatment to collect their experiences and perspectives on intimate relationships and sexual behavior with cervical cancer patients, and use the Colaizzi method for data analysis.

Results

Four themes were identified through the interview analysis: (1) reduction or absence of sexual behavior, (2) unpleasant sexual experiences, (3) adjustment of intimate relationships, and (4) lack of sexual health education.

Conclusion

The sexual partners of young cervical cancer patients have experienced significant shifts in their perspectives on sexual behavior and intimate relationships. These changes include reduction or absence of sexual behavior, unpleasant sexual experiences, adjustment of intimate relationships, and lack of sexual health education. Hospitals should pay more attention to the sexual behavior and intimate relationships of patients with cervical cancer and their sexual partners, and social support systems and psychological and emotional counselling services should be established for providing relevant knowledge and guidance.