Bravington, Alison, Chen, Hong, Dyson, Judith, Jones, Lesley, Dalgliesh, Christopher, Bryan, Amée, Patnick, Julietta and Macleod, Una (2022) Challenges and opportunities for cervical screening in women over the age of 50 years : a qualitative study. British Journal of General Practice . doi:10.3399/BJGP.2022.0036 ISSN 0960-1643. (In Press)

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Abstract

Background Cervical cancer is a preventable disease. Cases in women age >50 years are predicted to rise by 60% in the next two decades, yet this group are less likely to attend for screening than younger women.

Aim To seek novel solutions to the challenges of cervical screening in women >50 years of age by examining practitioner and service-user experiences.

Design and setting Semi-structured interviews were conducted with 28 practitioners and 24 service users >50 years of age, recruited via UK primary care networks in Northern England in 2016–2017, to explore experiences related to cervical screening.

Method An inductive thematic analysis was conducted to explore the data.

Results Findings are presented under three key themes. The first, exploring the barriers to successful cervical screening, examines the influences of sexuality and early experiences of screening on attendance, and how preventive health care becomes a low priority as women age. The second, the role of relationships, explores how peer talk shapes attitudes towards cervical screening, how teamwork between practitioners engenders investment in cervical screening, and how interactions between service users and primary care over time can significantly affect intentions to screen. The third, what constitutes good practice, describes practical and sensitive approaches to screening tailored to women aged >50 years.

Conclusion Good practice involves attention to structural and practical challenges, and an understanding of the role of relationships in shaping screening intentions. Experienced practitioners adapt procedures to increase sensitivity, and balance time invested in problem solving against the benefits of reaching practice targets for attendance. Building networks of expertise across multiple practices can increase practitioner skill in screening this age group.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cervix uteri -- Cancer -- Diagnosis -- Great Britain, Medical screening -- Great Britain, Women -- Diseases -- Diagnosis, Cancer -- Diagnosis -- Research, Older people, Medical screening -- Great Britain -- Prevention
Journal or Publication Title:	British Journal of General Practice
Publisher:	Royal College of General Practitioners
ISSN:	0960-1643
Official Date:	2022
Dates:	Date Event 2022 Published 3 October 2022 Available 29 April 2022 Accepted
DOI:	10.3399/BJGP.2022.0036
Status:	Peer Reviewed
Publication Status:	In Press
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	21 November 2022
Date of first compliant Open Access:	21 November 2022
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID H393 Yorkshire Cancer Research http://dx.doi.org/10.13039/100011703

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