IDEAS home Printed from
   My bibliography  Save this paper

A synthesis of qualitative research on cervical cancer screening behaviour: Women?s perceptions of the barriers and motivators to screen and the implications for policy and practice, CHERE Working Paper 2006/7


  • Marion Haas

    () (CHERE, University of Technology, Sydney)

  • Sandy Fowler

    () (CHERE, University of Technology, Sydney)


Cervical cancer is one of the most preventable and treatable cancers. It has been estimated that up to 90% of the most common type of cervical cancer may be prevented if cell changes are detected and treated early. Early detection is undertaken using a Pap test. In most Western countries, including Australia, and in many less developed countries, screening for cervical cancer is provided to women in the form of an organised program. These programs typically provide Pap tests free or at low cost, at the point of delivery. However, as most cancers occur in women who have never or rarely screened, increasing the rate of screening remains an important issue. Numerous studies have identified the variables associated with women rarely or never screening. Older, poorer women, women living in rural communities and those from non-European ethnic backgrounds (in Australia, especially those who do not speak English) are much less likely to screen than their younger, richer, urban-dwelling, English-speaking sisters. This type of information can be used to target women less likely to screen but does not address what women perceive to be the major barriers to their having a Pap test or what messages might be most effective in convincing them to have the test. A number of qualitative studies have examined these issues. In this project, the results of such studies have been synthesised in an attempt to answer two questions: 1. Why don?t some women have Pap tests? 2. What would work to encourage women who currently do not screen to change their behaviour? This synthesis adopted the meta-ethnographic approach as described in Campbell et al (2003). The results from 16 papers were appraised in terms of the quality of the research undertaken as well as results and conclusions. The results indicate that the majority of women have heard of or know about the Pap test. However, many were misinformed about the details of the test and its implications. Women may not think a Pap test is relevant for them for a number of reasons: many believe that it detects cancer (rather than cervical abnormalities which may or may not be pre-cancerous lesions). This may lead to under-screening if a woman is afraid of cancer or believes that screening is only necessary if and when symptoms appear. Women may also not screen if their cultural and/or religious beliefs connect cervical cancer with sexually transmitted infections acquired as the result of pre-marital or extra-marital sexual contact (ie promiscuity). Common barriers to accessing Pap tests included the direct cost of the test and various opportunity costs in terms of time and availability of childcare. The lack of availability of female health care providers was also an important barrier. The synthesis has indicated that there are some standard preferences and barriers which cross cultural, demographic and socio-economic lines that could be considered by practitioners and policy makers attempting to improve services and increase screening uptake. Practitioners can encourage women to screen by emphasising the curable nature of cervical lesions, being honest about the relationship between sexual activity and cervical cancer and explicitly recommending a Pap test. There is also a need for more individually tailored approaches to target specific ethnic groups. An understanding of community-specific beliefs is invaluable to health professionals if they are to provide cultural sensitive and appropriate services.

Suggested Citation

  • Marion Haas & Sandy Fowler, 2006. "A synthesis of qualitative research on cervical cancer screening behaviour: Women?s perceptions of the barriers and motivators to screen and the implications for policy and practice, CHERE Working Pap," Working Papers 2006/7, CHERE, University of Technology, Sydney.
  • Handle: RePEc:her:chewps:2006/7

    Download full text from publisher

    File URL:
    File Function: First version, 2006
    Download Restriction: no

    References listed on IDEAS

    1. Campbell, Rona & Pound, Pandora & Pope, Catherine & Britten, Nicky & Pill, Roisin & Morgan, Myfanwy & Donovan, Jenny, 2003. "Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care," Social Science & Medicine, Elsevier, vol. 56(4), pages 671-684, February.
    Full references (including those not matched with items on IDEAS)

    More about this item


    Cervical cancer; screening; Pap tests;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:her:chewps:2006/7. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Liz Chinchen). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.