title: Reasons for non-attendance to cervical screening and preferences for HPV self-sampling in Dutch women.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Remko P
authors.initials: RP
authors.lastname: Bosgraaf
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Pleun.Ketelaars@radboudumc.nl.
authors.forename: Pleun J W
authors.initials: PJ
authors.lastname: Ketelaars
authors.affiliation: Department of Pathology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Viola M J
authors.initials: VM
authors.lastname: Verhoef
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
authors.affiliation: Department of Pathology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Willem J G
authors.initials: WJ
authors.lastname: Melchers
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Ruud L M
authors.initials: RL
authors.lastname: Bekkers
mesh_terms: D000328:Adult; D017677:Age Distribution; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D065006:Papanicolaou Test / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data; D012648:Self Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D013048:Specimen Handling / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors; D014626:Vaginal Smears / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D016387:Women's Health
keywords: Early detection of cancer; HPV self-sampling; Non-attendance; Questionnaires; Screening; Uterine cervical neoplasms