A population survey on beliefs around cervical cancer screening: determining the barriers and facilitators associated with attendance
Open accessAbstract
Background: 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. Methods: 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. Results: 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. Conclusions: 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.
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In the United Kingdom, prioritising screening was the strongest predictor of regular CC screening.
“In the United Kingdom, prioritising screening was the strongest predictor of regular CC screening [13].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [13]
The Discussion identifies prioritising cervical screening as the strongest predictor of reported past attendance, but also names memory among the strongest predictors of regular attendance. The study surveyed women in London and measured self-reported attendance; it does not establish the finding for the United Kingdom as a whole. (LLM, conf=0.87)
Experimental — accuracy not yet measuredCompeting life demands such as other diseases, childcare responsibility, no possibility to take time off, and being busy with housework are widely cited barriers.
“Barriers such as other diseases, responsibility of childcare, no possibility to take time off, and being busy with housework are widely cited [9,13,22,23,30].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [13]
The Discussion (page unavailable) says that lack of time and childcare are commonly reported barriers to cervical screening, and links competing commitments with lower attendance. It does not specifically identify other diseases, inability to take time off, or housework as barriers. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn a United Kingdom-based study, remembering to book and attend screening was one of the strongest predictors of regular cervical cancer screening attendance.
“In a the United Kingdom-based study, remembering to book and attend screening was one of the strongest predictors of regular CC screening attendance [13].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [13]
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- Authors
- Judah, G., Dilib, F., Darzi, A., & Huf, S.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Judah, Gaby
- Venue
- BMC Cancer
- Published
- 2022-05-09
- Volume
- 22
- Issue
- 1
- Pages
- 522-522
- ISSN
- 1471-2407 (ISSN-L)
- PMC
- PMC9082843
- OpenAlex
- W4229363447
- Cited by
- 24
- References
- 26
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 4 · 2023: 2 · 2022: 3
- FWCI
- 3.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Cancer (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (NF-SI-0510-10186, NF-SI-0617-10038)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer screening, screening uptake, barriers and facilitators, Theoretical Domains Framework, household income, relationship status, sexual activity, sexually transmitted infections, risk perception, memory, environmental context and resources, intention, London
- MeSH terms
- Adult, Aged, Uterine Cervical Neoplasms, Ethnicity, Female, Humans, Mass Screening, Middle Aged, Surveys and Questionnaires, Early Detection of Cancer
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