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Perspectives of non-attenders for cervical cancer screening in Norway: a qualitative focus group study
  1. Gunvor Aasbø1,2,
  2. Kari Nyheim Solbrække2,
  3. Jo Waller3,
  4. Ameli Tropé4,
  5. Mari Nygård1,
  6. Bo Terning Hansen1
  1. 1Department of Research, Cancer Registry of Norway, Oslo, Norway
  2. 2Institute of Health and Society, University of Oslo, Oslo, Norway
  3. 3Department of Behavioural Science and Health, Institute of Epidemiology and Public Health, University College London, London, UK
  4. 4Cervical Cancer Screening Programme, Cancer Registry of Norway, Oslo, Norway
  1. Correspondence to Dr Gunvor Aasbø; gunvoraa{at}


Objective The attendance rate for cervical cancer screening in Norway is currently suboptimal at 69%, and an in-depth understanding of postponement of cervical cancer screening from the perspective of non-attenders is lacking. This study aims to generate knowledge about how non-attenders for cervical cancer screening reflect on booking a screening appointment.

Methods Using the Norwegian cervical cancer screening registry, we identified and recruited women who were non-attenders to screening. Nine focus group interviews were carried out, with 41 women participating in the interviews.

Results Four main themes were generated, which provide a comprehensive understanding of how women who are overdue for screening reflect on their hesitancy to book a screening appointment: ‘It’s easy to forget about it’, ‘Women have to arrange their own appointment’, ‘It has to be a ‘must’’ and ‘It’s a humiliating situation’.

Conclusion The degree to which women regard screening as important is affected by the nudging strategies employed in the screening programme and the facilitation of attendance provided by healthcare services. Dependence on one’s personal initiative to schedule a screening appointment and perception of a lack of responsibility on the part of healthcare services to attend screening may undermine informed and shared decision-making about screening attendance.

  • qualitative research
  • preventive medicine
  • cervical cancer screening
  • non-attendance
  • invitation strategy

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  • Contributors BTH, KNS, MN and AT conceived and designed the study. BTH and AT facilitated the recruitment of the participants. GA recruited the participants. GA was responsible for data collection with support and guidance from KNS, MN and JW. GA and KNS coded and thematically analysed the data. GA drafted the manuscript. All authors commented on manuscript drafts and accepted the final version of the manuscript.

  • Funding This work was supported by the Norwegian Cancer Society, grant number (182687-2016) and Thea Steen Memorial Fund.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the privacy ombudsman at the Oslo University Hospital (ref. 2017/10642).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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