Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women

Prev Med. 2014 Jul:64:108-13. doi: 10.1016/j.ypmed.2014.04.011. Epub 2014 Apr 13.


Objectives: High attendance rates in cervical screening are essential for effective cancer prevention. Offering HPV self-sampling to non-responders increases participation rates. The objectives of this study were to determine why non-responders do not attend regular screening, and why they do or do not participate when offered a self-sampling device.

Methods: A questionnaire study was conducted in the Netherlands from October 2011 to December 2012. A total of 35,477 non-responders were invited to participate in an HPV self-sampling study; 5347 women did opt out. Finally, 30,130 women received a questionnaire and self-sampling device.

Results: The analysis was based on 9484 returned questionnaires (31.5%) with a self-sample specimen, and 682 (2.3%) without. Among women who returned both, the main reason for non-attendance to cervical screening was that they forgot to schedule an appointment (3068; 32.3%). The most important reason to use the self-sampling device was the opportunity to take a sample in their own time-setting (4763; 50.2%). A total of 30.9% of the women who did not use the self-sampling device preferred after all to have a cervical smear taken instead.

Conclusions: Organisational barriers are the main reason for non-attendance in regular cervical screening. Important reasons for non-responders to the regular screening to use a self-sampling device are convenience and self-control.

Keywords: Early detection of cancer; HPV self-sampling; Non-attendance; Questionnaires; Screening; Uterine cervical neoplasms.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Age Distribution
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Middle Aged
  • Netherlands
  • Papanicolaou Test / methods
  • Papanicolaou Test / psychology*
  • Papanicolaou Test / statistics & numerical data
  • Papillomavirus Infections / diagnosis*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Preference / psychology
  • Patient Preference / statistics & numerical data
  • Self Care / methods
  • Self Care / psychology
  • Self Care / statistics & numerical data
  • Specimen Handling / methods
  • Surveys and Questionnaires
  • Time Factors
  • Vaginal Smears / methods
  • Vaginal Smears / psychology*
  • Vaginal Smears / statistics & numerical data
  • Women's Health*