'I do not need to... I do not want to... I do not give it priority...'--why women choose not to attend cervical cancer screening

Health Expect. 2008 Mar;11(1):26-34. doi: 10.1111/j.1369-7625.2007.00478.x.


Objective: To describe and interpret why women with no cervical smear taken during the previous 5 years choose not to attend a cervical cancer screening (CCS) programme.

Background: CCS programme is a service for early detection of cervical cancer. Today, some women choose not to attend the programme.

Design: Data were collected by tape-recorded interviews and analysed by qualitative inductive content analysis.

Setting and participants: Purposive sample of 14 women in southeast Sweden, who had chosen not to attend CCS during the previous 5 years.

Findings: The following themes were revealed: I do not need to..., I do not want to... and I do not give it priority.... The women had a positive attitude to CCS but as long as they felt healthy, they chose not to attend. A negative body image, low self-esteem, feelings of discomfort when confronted with the gynaecological examination and fear of the results also influenced their non-attendance. The women prioritized more important things in life and reported various degrees of lack of trust in health-care.

Conclusion: Women's choice not to attend CCS were complex and influenced by present and earlier intra- and inter-personal circumstances. They had a positive attitude to CCS, but other things in life were more important. Health-care professionals have to facilitate a co-operative discussion with the women in order to contribute to a mutual understanding for the perspectives of the women and the professionals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Decision Making
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Mass Screening / methods
  • Mass Screening / psychology*
  • Middle Aged
  • National Health Programs
  • Patient Compliance / psychology
  • Sweden
  • Treatment Refusal / psychology*
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / psychology*