Promoting health by empowering women, strengthening partnerships, and enhancing health care systems: One Pap test at a time

M. Victoria Greenslade, Kathy Fitzgerald, Irene Doyle Barry, Kelly Power-Kean

Abstract


Invasive cervical cancer, a highly preventable disease, is the thirteenth most common form of cancer among Canadian women and third amongst those women 20 to 40 years of age (Public Health Agency of Canada [PHAC], 2009). Health care providers (HCP)s know that adherence to the Canadian recommendations for regular screening, using the Pap test, reduces incidence and mortality rates (Marcus & Crane, 1998). Yet, only 30% of women in Newfoundland and Labrador consistently participate in cervical screening (Newfoundland and Labrador CHI, 2006) and mortality rates are alarming. The most recent data reveal that the incidence in 1998 was 1.5 times the national average (Health Canada, 1998) while mortality was estimated at 2.5 times the national average (NLCHI, 2006). A two-phased study conducted in Newfoundland and Labrador sought an in-depth understanding of women’s perceptions, beliefs and attitudes associated with cervical cancer screening, reasons for non-participation, and personal insights to improve the screening experience. Seven main themes are identified: physical factors, emotional factors, life gets in the way, lack of education, health care providers, cultural impact, and birth control/pregnancy. Implications for nursing practice and future research are discussed.


Full Text:

PDF

References


Allen, K. (1992). Barriers women perceive for Pap screening.

Proceedings of the 7th International Conference on Cancer

Nursing: Changing Frontiers, Vienna.

Amankwah, E., Ngwakongnwi, E., & Kwan, H. (2009). Why many

visible minority women in Canada do not participate in cervical

cancer screening. Ethnicity and Health, 14(4), 337–349.

Amarin, Z.O., Badria, L.F., & Obeidat, B.R. (2008). Attitudes and

beliefs about cervical smear testing in ever-married Jordanian

women. Eastern Mediterrean Health Journal, 14(2), 389–397.

Anderson, J.O., Mullins, R.M., Siahpush, M., Spittal, M.J., & Wakefield, M.

(2009). Mass media campaign improves cervical screening across of

social-economic groups. Health Education Research, 24(5), 867–75.

Blomberg, K., Ternestedt, B-M., Tomberg, S., & Tishelman, C. (2008).

How do women who chose not to participate in population-based

cervical cancer screening reason about their decision? Psycho-

Oncology, 17, 561–569.

Blomberg, K. Tishelman, C., Ternestedt, B-M., Tornberg, S., Leval, A.,

& Widmark, C. (2011). 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. Acta Oncologica, 50(1), 112–20.

Buehler, S.K., & Parsons, W.L. (1997). Effectiveness of a call/recall

system in improving compliance with cervical cancer screening:

A randomized control trial. Canadian Medical Association

Journal, 157(5), 521–526.

Burnett, C.B., Steakley, C.S., & Tefft, M.C. (1995). Barriers to

breast and cervical cancer screening in underserved women

in the District of Columbia. Oncology Nursing Forum, 22(10),

–1557.

Canadian Cancer Society. Canadian Cancer Statistics 2004. Retrieved

from http://www.cancer.ca/Newfoundland-Labrador/About%20

cancer/Cancer%20statistics/Canadian%20Cancer%20Statistics.

aspx?sc_lang=en

Canadian Cancer Society. Canadian Cancer Statistics, 2005.

Retrieved from http://www.cancer.ca/~/media/CCS/Canada%20

wide/Files%20List/English%20files%20heading/pdf%20

not%20in%20publications%20section/Canadian%20Cancer%20

Statistics%20-%202005%20-%20EN%20-%20PDF_401594768.ashx

Canadian Cancer Society. Canadian Cancer Statistics, 2011.

Retrieved from http://www.cancer.ca/~/media/CCS/Canada%20

wide/Files%20List/English%20files%20heading/PDF%20-%20

Policy%20-%20Canadian%20Cancer%20Statistics%20-%20English/

Canadian%20Cancer%20Statistics%202011%20-%20English.ashx

Canadian Partnership Against Cancer (CPAC), 2009. Pan-Canadian

Forum on Cervical Cancer Prevention and Control in the HPV

vaccine era. Toronto: Author.

Canadian Partnership Against Cancer (CPAC), 2011. Cervical cancer

screening in Canada monitoring program performance 2006–

Toronto: Author.

Eaker, S., Adami, H.O., Granath, F., Wilander, E., & Sparén, P. (2004).

A large population-based randomized control trial to increase

attendance at screening for cervical cancer. Cancer Epidemiology

Biomarkers Prevention, 13(3), 346–54.

Fitch, M.I., Greenberg, M., Cava, M., Spaner, D., & Taylor, K. (1998).

Exploring the barriers to cervical screening in an urban Canadian

setting. Cancer Nurse, 21(6), 441–449.

Forbes, C., Jepson, R., & Martion-Hirsh, P. (2002). Interventions

targeted at women to encourage the uptake of cervical screening.

Cochrane Data Base System Review, (3):CD002834.

Fylan, F. (1998). Screening for cervical cancer: A review of women’s

attitudes, knowledge, and behaviour. British Journal of General

Practice, 48, 1509–1514.

Gannon, M., & Dowling, M. (2008). Increasing the uptake of cervical

screening programmes. British Journal of Nursing, 17(20),

–1284.

Harokopos, V., & McDermott, R.J. (1996). Cervical cancer screening:

Benefits and barriers. Journal of Health Education, 7(6),

–356.

Health Canada. (1998). Cervical cancer screening in Canada: 1998

surveillance report. Ottawa: Author.

Hislop, T.G., Clarke, H.F., Deschamps, M., Joseph, R., Band, P.R.,

Smith, J., … Atleo, R. (1996). Cervical cytology screening. How

can we improve rates among First Nations women in urban

British Columbia. Canadian Family Physician, 42, 1701–1708.

Hislop, T.G., Deschamps, M., Teh, C., Jackson, C., Tu, S-P, Yasui, Y.,

… Taylor, V. (2003). Facilitators and barriers to cervical cancer

screening among Chinese women. Canadian Journal of Public

Health, 94(1), 68–73.

Ho, V., Yamal, J.M., Atkinson, E.N., Basen-Engquist, K., Tortolero-

Luna, G., & Follen, M. (2005). Predictors of breast and cervical

screening in Vietnamese women in Harris County, Houston,

Texas. Cancer Nursing, 28(2), 119–128.

Jensen, H., Svanholm, H., Stoevring, H., & Bro, F. (2009). A primary

healthcare based intervention to improve a Danish cervical

cancer screening program—A cluster randomized controlled

trial. Journal of Epidemiology and Community Health, 63(7),

–5.

Langille, D., & Rigby, J. (2006). Factors associated with PAP testing in

adolescents in Northern Nova Scotia. Canadian Journal of Public

Health, 183, Retrieved from http://elibrary.bigchalk.com

Lockwood-Rayermann, S. (2004). Characteristics of participation in

cervical cancer screening. Cancer Nursing, 27(5), 353–363.

Lovell, S., Kearns, R.A., & Friesen, W. (2007). Sociocultural barriers

to cervical screening in South Auckland, New Zealand. Social

Science and Medicine, 65, 138–150.

Marcus, A.C., & Crane, L.A. (1998). A review of cervical cancer

screening intervention research: Implications for public health

programs and future research. Preventative Medicine, 27(1),

–31.

Maxwell, C.J., Bancej, C.M., Snider, J., & Vik, S.A. (2001). Factors

important in promoting cervical cancer screening among

Canadian women: Findings from the 1996-97 National Population

Health Survey (NPHS). Canadian Journal of Public Health, 92(2),

–133.

Miedema, B., & Tatemichi, S. (2003). Breast and cervical cancer

screening for women between 50 and 69 years of age: What

prompts women to screen? Women’s Health Issues 13,

–184.

Newfoundland and Labrador Centre for Health Information

(NLCHI). (2006). Development of a composite administrative

database for the study of cervical cancer and cervical screening

in Newfoundland and Labrador: Final report. Newfoundland and

Labrador. Author.

Oscarsson, M.G., Wijma, B.E., & Benzein, E.G. (2008). ‘I do not need …

I do not want… I do not give it priority…’—Why women choose

not to attend cervical cancer screening. Health Expectations, 11,

–34. 10.1111/j.1369-7625.2007.00478.x

Public Health Agency of Canada (PHAC). (2009). Report from the

screening performance indicators working group, cervical

cancer prevention and control network (CCPCN): Performance

monitoring for cervical screening programs in Canada. Ottawa:

Author.

Speziale, H., & Carpenter, D. (2003). Qualitative research in nursing.

Advancing the humanistic imperative. Philadelphia: Lippincott,

Williams, & Wilkins.

Twinn, S., & Cheng, F. (2000). Increasing uptake rates of cervical

cancer screening amongst Hong Kong Chinese women: The

role of the practitioner. Journal of Advanced Nursing, 32(2),

–42.

Van Manen, M. (1990). Researching lived experience: Human science

for an action sensitive pedagogy. Albany: State University of New

York Press.

Van Til, L., MacQuarrie, C., & Herbert, R. (2003). Understanding the

barriers to cervical screening among older women. Qualitative

Health Research, 13(8), 1116–1131.

Warman, J. (2010). Cervical cancer screening in young women:

Saving lives with prevention and detection. Oncology Nursing

Forum, 37(1), 33–38.


Refbacks

  • There are currently no refbacks.