title: How can young women be encouraged to attend cervical cancer screening? Suggestions from face-to-face and internet focus group discussions with 30-year-old women in Stockholm, Sweden.
abstract: BACKGROUND
  cervical cancer screening (CCS) using Pap-smears has been carried out for decades and is still an essential tool for secondary cancer prevention. Focus has traditionally been on what hinders women's attendance, instead of researching this issue from a positive standpoint, i.e. what factors encourage women to take a Pap-smear? In this article, we therefore explore issues that 30-year-old women have addressed as encouraging CCS attendance, with particular focus on aspects susceptible to intervention.
  
  
  METHODS
  through the population-based cervical cancer screening (PCCSP) registry in Stockholm, Sweden, a stratified random sampling technique was used to recruit women from the same birth cohort with varied CCS histories and results. Nine face-to-face focus groups discussions (FGDs) and 30 internet-based FGDs were conducted with a total of 138 women aged 30. Qualitative analysis was inspired by interpretative description, to generate clinically relevant and useful data.
  
  
  RESULTS
  in general, these women expressed positive views about the PCCSP as an existing service, regardless of screening history. They described a wide range of factors encompassing the entire screening trajectory from invitation through follow-up which could motivate young women to CCS participation, including social marketing. Many of the suggestions related to individualization of the PCCSP, as well as a need to understand the relationship between human papilloma virus (HPV) and cervical cancer.
  
  
  CONCLUSIONS
  [corrected these results are discussed in terms of the inherent tension between population-based public health initiatives and individually-oriented health care provision. Many suggestions given are already incorporated into the existing Stockholm-Gotland screening program, although this information may not reach women who need it. New research should test whether systematic information on HPV may provide a missing link in motivating young women to attend CCS, and which of their suggestions can serve to increase CCS participation.
authors.affiliation: Department NVS, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. karin.blomberg@oru.se
authors.forename: Karin
authors.initials: K
authors.lastname: Blomberg
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Ternestedt
authors.forename: Sven
authors.initials: S
authors.lastname: Törnberg
authors.forename: Amy
authors.initials: A
authors.lastname: Levál
authors.forename: Catarina
authors.initials: C
authors.lastname: Widmark
mesh_terms: D000328:Adult; D003071:Cognition; D032882:Comprehension; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D018456:Reproductive Medicine; D012494:Sampling Studies; D040241:Social Marketing; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000523:psychology / Q000821:virology; D014626:Vaginal Smears; D016387:Women's Health