title: Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study.
abstract: OBJECTIVE
  To explore differences in barriers to attendance at cervical screening across age groups because coverage of the cervical screening programme in England has been falling, particularly among women in the youngest age group (25-29 years).
  
  
  METHODS
  A qualitative study.
  
  
  METHODS
  A university in London.
  
  
  METHODS
  Professionals working in the screening field (n=12) and women of varying ages who had either never attended for cervical screening or did not attend regularly (n=46).
  
  
  METHODS
  In Study 1 we interviewed professionals to elicit their views on the reasons for lower screening attendance in young women. In Study 2, we carried out four focus groups (n=27) and 19 individual interviews with under-screened women to explore their barriers to attendance. Verbatim transcripts were analysed using Framework Analysis.
  
  
  RESULTS
  Reasons for nonattendance were many and varied. Health professionals identified population-level factors, service provision issues, time pressures, risk perceptions, lack of knowledge and psychological barriers. The nonattenders fell into two groups: those who had made an active decision not to take part (who tended to be older), and those who intended to be screened but did not attend (predominantly younger women). Practical barriers were raised more often by younger women whereas older women had more negative attitudes to screening.
  
  
  CONCLUSIONS
  This study provides rich data on the complex reasons why women do not attend for cervical screening. It points to age differences in barriers to screening, and suggests that addressing practical issues such as appointment systems and clinic times may have a positive impact on attendance in young women.
authors.affiliation: Cancer Research UK Health Behaviour Research Centre Psychobiology Group, Department of Epidemiology and Public Health, UCL, London, UK. j.waller@ucl.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Waller
authors.forename: M
authors.initials: M
authors.lastname: Jackowska
authors.forename: L
authors.initials: L
authors.lastname: Marlow
authors.forename: J
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D057565:Apathy; D001291:Attitude of Health Personnel; D004739:England; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D026706:Paternalism; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010465:Perception; D012307:Risk Factors; D013997:Time Factors; D014171:Transients and Migrants / Q000523:psychology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology*