Volume 111 Pages 1-476 (June 2018)
Variation in health beliefs across different types of cervical screening non-participants
Open access – Original research article
Laura A.V. Marlow, Rebecca A. Ferrer, Amanda J. Chorley, Jessica B. Haddrell, Jo Waller
Understanding factors associated with different types of cancer screening non-participation will help with the development of more targeted approaches for improving informed uptake. This study explored patterns of general health beliefs and behaviour, and cancer-specific beliefs across different types of cervical screening non-participants using the Precaution Adoption Process Model (PAPM). A population-representative sample of women in Britain completed a home-based survey in 2016. Women classified as non-participants (n=839) completed additional questions about health beliefs.
Some general health beliefs and behaviours, as well as cancer-specific beliefs, were associated with particular types of non-participation. For example, those who scored higher on fatalism were more likely to be unaware of screening (OR=1.74, 95%CI: 1.45–2.08) or unengaged with screening (OR=1.57, CI: 1.11–2.21). Women with greater deliberative risk perceptions were less likely to be unengaged with screening (OR=0.74 CI: 02.55–0.99) and less likely to have decided against screening (OR=0.71, CI: 0.59–0.86). Women who had seen a general practitioner in the last 12 months were less likely to be unaware (O=0.49, CI: 0.35–0.69), and those reporting cancer information avoidance were more likely to be unengaged with screening (OR=2.25, CI: 1.15–4.39). Not wanting to know whether one has cancer was the only factor associated with all types of non-participation.
Interventions to raise awareness of screening should include messages that address fatalistic and negative beliefs about cancer. Interventions for women who have decided not to be screened could usefully include messages to ensure the risk of cervical cancer and the relevance and benefits of screening are well communicated.