Women who might benefit most from breast and cervical cancer screening are the most hesitant to receive it, and the barriers that hold them back are often based on misinformation, suggest the results of a study.
Since previous research has shown that cancer rates are higher among those who never receive screening tests, special programs are needed to focus specifically on those women who do not receive regular mammograms or Pap smears.
“Screening programs that focus on such individuals may return greater benefits at much lower cost than do indiscriminate ‘blanket screening’ programs,” said lead author Russell E. Glasgow, PhD, of the AMC Cancer Research Center, in Lakewood, CO.
In a survey of more than 500 women aged 52-69, the researchers found that study participants who had neither a mammogram in two years nor a Pap smear in three years were the most likely to report reasons for avoiding screening.
Participants who needed only one test came in second in terms of barriers, and those who had received both tests reported the fewest and least intense barriers. The researchers found great similarity in the barriers reported most often for both types of cancer screening.
“Just meeting current cancer screening guidelines does not ensure that the women who are most at risk and who most need screening get it,” said “It is crucial that health care systems focus on this subgroup of women,” he added.
Feeling healthy and having no family cancer history was the top reason study participants cited for avoiding screening. The second most common barrier was a fear that the screening test would be embarrassing and uncomfortable, the researchers found.
Other barriers to screening were the inconvenience of screening appointments; the fear that if cancer were detected the cure would be worse than the disease; and the belief that screening tests are inaccurate.
Except for appointment problems, these reasons are based on misinformation, according to the researchers. “This suggests that interventions might focus on correcting these misconceptions,” said Glasgow.
Glasgow and colleagues recommend letters or telephone counseling and support tailored to the particular barriers women face.
The researchers report their findings in the current issue of Annals of Behavioral Medicine. This research was supported by a grant from the National Cancer Institute.
Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact Robert Kaplan, PhD, 619-534-6058.
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Journal
Annals of Behavioral Medicine