title: What attendance rate can be achieved for Pap smear screening? A case-control study of the characteristics of non-attenders and results of reminder efforts.
abstract: OBJECTIVE
  To understand participation failures in a national Pap smear screening programme by studying characteristics of non-attenders and results of further reminder efforts.
  
  
  METHODS
  A case-control and an intervention study.
  
  
  METHODS
  The community health centre in the town of Hafnarfjördur, Iceland.
  
  
  METHODS
  The target population comprised 2510 women aged 35-69, who were invited regularly every second year for cervical cancer screening.
  
  
  RESULTS
  2241 (89.3%) had attended screening during the preceding five years, 102 (4.1%) had never attended, and 167 (6.7%) had attended previously but not during the preceding five years. Women with a mental disorder and those who had never married were more likely not to attend. The most usual explanations given by non-attenders were that they did not like to participate, or they felt they did not need to, some of them because their uterus had been removed. Of the non-attenders 29 (10.8%) came for a Pap smear after repeated reminding efforts.
  
  
  CONCLUSIONS
  Total participation rate in cervical cancer screening programmes in Iceland is high. When efforts are taken to lower the non-attendance rate it has to be kept in mind that many women are unwilling or unable to participate in such preventive measures.
authors.affiliation: Department of Family Medicine, Solvangur Health Centre, University of Iceland, Iceland.
authors.forename: J B
authors.initials: JB
authors.lastname: Bergmann
authors.forename: J A
authors.initials: JA
authors.lastname: Sigurdsson
authors.forename: K
authors.initials: K
authors.lastname: Sigurdsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007055:Iceland; D017533:Marital Status; D008875:Middle Aged; D065006:Papanicolaou Test; D017010:Reminder Systems; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014626:Vaginal Smears / Q000706:statistics & numerical data*