title: When Life Got in the Way: How Danish and Norwegian Immigrant Women in Sweden Reason about Cervical Screening and Why They Postpone Attendance.
abstract: BACKGROUND
  Danish and Norwegian immigrant women in Sweden have an increased risk of cervical cancer compared to Swedish-born women. In addition, Danish and Norwegian immigrant women follow the national recommendations for attendance at cervical screening to much lesser extent than Swedish-born women. The aim of this study was to explore how Danish and Norwegian immigrant women in Sweden reason about attending cervical screening, focusing on women's perceptions as to why they and their compatriots do not attend.
  
  
  METHODS
  Eight focus group discussions (FGDs) were conducted with Danish and Norwegian immigrant women living in Stockholm. The women were between 26 and 66 years of age at the time of the FGDs, and were aged between <1 and 48 years old when they immigrated to Sweden. A FGD guide was used, which included questions related to cervical screening, and obstacles and motivators to attend cervical screening. The FGDs were tape recorded and transcribed, and the results analysed according to the principles of qualitative content analysis.
  
  
  RESULTS
  The main theme was "Women have a comprehensive rationale for postponing cervical screening, yet do not view themselves as non-attenders". Investigation of women's rationale for non-attendance after being invited to cervical screening revealed some complex reasons related to immigration itself, including competing needs, organisational and structural factors and differences in mentality, but also reasons stemming from other factors. Postponing attendance at cervical screening was the category that linked all these factors as the reasons to why women did not attend to cervical screening according to the recommendations of the authorities.
  
  
  CONCLUSIONS
  The rationale used to postpone cervical screening, in combination with the fact that women do not consider themselves to be non-attenders, indicates that they have not actively taken a stance against cervical screening, and reveals an opportunity to motivate these women to attend.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Fatima
authors.initials: F
authors.lastname: Azerkan
authors.affiliation: Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Catarina
authors.initials: C
authors.lastname: Widmark
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Pär
authors.initials: P
authors.lastname: Sparén
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Community Medicine, Faculty of Health Sciences, University of Tromso, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Samfundet Folkhälsan, Helsinki, Finland.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden; Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Tillgren
authors.affiliation: Department of Public Health Sciences, Global Health (IHCAR) Karolinska Institutet, Stockholm, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Faxelid
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark; D055088:Early Detection of Cancer; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009664:Norway; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care; D010465:Perception; D060756:Social Networking; D012944:Social Support; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*