Department of Surgery and Cancer, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.
BMC Cancer. 2022 May 9;22(1):522. doi: 10.1186/s12885-022-09529-w.
Cervical screening saves approximately 5000 lives annually in England. However, screening rates have been falling continuously, and coverage in London is particularly low (64.7%). While demographic predictors of uptake have been well researched, there has been less thorough investigation of the individual barriers and facilitators which predict cervical screening attendance. Understanding modifiable factors influencing attendance can guide the design of effective interventions to increase cervical screening uptake. The aim of this study was to understand the demographic, and individual factors associated with self-reported attendance at cervical screening in London.
The study used an online survey of 500 women in London (June-July 2017). The survey included self-reported measures of past attendance, demographic variables (including age, household income, ethnicity), past experience variables, and individual variables (list of potential barriers and facilitators developed based on the Theoretical Domains Framework and existing literature, which included: environmental context and resources, perceived risk, anticipated pain/embarrassment). Participants were categorised into regular attenders and non-regular attenders. Backwards stepwise logistic regression investigated the barriers and facilitators predicting past attendance. Demographic variables with significant differences between regular and non-regular attenders were added to the final regression model.
Of women who had previously been invited (n = 461, age range: 25-65), 34.5% (n = 159) were classified as non-regular attenders, and 65.5% (n = 302) as regular attenders. The individual barriers and facilitators predicting attendance were: cervical screening priority, memory, environmental context and resources, and intention. The only demographic variables related to regular attendance were relationship status (married/civil partnership having higher rates than single) and higher household income. Relationship status was not significant when adjusting for barriers and facilitators. Those who have ever been sexually active or who have had an STI in the past were significantly more likely to be regular attenders.
The study shows the importance of individual barriers and facilitators in predicting self-reported cervical screening attendance. Household income was the only significant demographic variable when combined with the individual variables. Interventions targeting priority, memory, and practical barriers affecting environmental context may be expected to be effective an increasing attendance.
在英格兰，宫颈筛查每年可挽救约 5000 条生命。然而，筛查率一直在持续下降，伦敦的覆盖率尤其低（64.7%）。尽管已经对接受度的人口统计学预测因素进行了充分研究，但对预测宫颈筛查参与度的个人障碍和促进因素的研究还不够深入。了解影响参与度的可改变因素可以指导设计有效的干预措施，以提高宫颈筛查的参与度。本研究旨在了解与伦敦宫颈筛查自我报告参与度相关的人口统计学和个体因素。
该研究使用了一项针对伦敦 500 名女性的在线调查（2017 年 6 月至 7 月）。该调查包括过去参与度的自我报告指标、人口统计学变量（包括年龄、家庭收入、族裔）、过去的经验变量以及个体变量（根据理论领域框架和现有文献开发的潜在障碍和促进因素清单，其中包括：环境背景和资源、感知风险、预期的疼痛/尴尬）。参与者被分为定期参与者和非定期参与者。向后逐步逻辑回归调查了预测过去参与度的障碍和促进因素。将在定期和非定期参与者之间有显著差异的人口统计学变量添加到最终回归模型中。
在之前被邀请过的女性中（n=461，年龄范围：25-65 岁），34.5%（n=159）被归类为非定期参与者，65.5%（n=302）为定期参与者。预测参与度的个体障碍和促进因素包括：宫颈筛查的优先级、记忆力、环境背景和资源以及意图。与定期参与相关的唯一人口统计学变量是婚姻状况（已婚/同居的比例高于单身）和更高的家庭收入。在调整障碍和促进因素后，婚姻状况不再显著。过去有过性行为或曾患有性传播感染的人更有可能定期参与。
本研究表明，个体障碍和促进因素在预测自我报告的宫颈筛查参与度方面的重要性。家庭收入是与个体变量结合时唯一显著的人口统计学变量。针对优先级、记忆和影响环境背景的实际障碍的干预措施可能有望提高参与度。
