Improving the coverage and quality of cervical screening: women's views

Background This study explored women's views on cervical screening following the introduction of the 1990 general practitioner (GP) contract, which has had a major impact on the approach to screening in general practices. Methods A total of 173 women of screening age attending surgeries at six practices in Blackburn, Hyndburn and Ribble Valley district completed questionnaires in their GP surgery. Results Reasons for non-attendance for screening included both administrative failures and reasons related to beliefs and attitudes. The change felt most likely to improve coverage was more successful health education. Threequarters of women who had had a smear made positive comments on their experience, but when asked specifically about the information they had received, three-quarters felt that this had been inadequate. Fewer than half of women questionnaire respondents were willing to suggest possible causes for cervical cancer and fewer than half were aware that the risk of cervical cancer was low following treatment for an abnormality found on screening. Around one-fifth of women continue to prefer a woman smear taker; of the 33 per cent expressing a preference for either a doctor or a nurse, opinion was roughly evenly divided between the two. Six per cent disliked having to wait so long for test results. Conclusions This work suggests that within the established agenda for developing high-quality screening programmes, improvements in health education may have the most impact from the viewpoint of women.