Cancer screening fear is fuelled by lack of information
29 June 2009
Fear plays a major role in whether women decide to go for cancer
screening or not, but healthcare providers underestimate how much women
need to know and wrongly assume that they will ask for information if
they want it.
Those are the two key findings from a study published in the June
issue of the Journal of Advanced Nursing.
US researchers Dr Kelly Ackerson and Dr Stephanie Preston reviewed 19
studies that between them explored the attitudes of 5,991 women to
breast and cervical cancer screening. The studies, which covered the
period 1994 to 2008, included women of all ages, from 14 year-old
teenagers to women in their eighties.
“Our review showed that fear could motivate women to either seek
screening or to avoid screening,” says nurse researcher Dr Ackerson, an
Assistant Professor at Western Michigan University, USA.
“Some women complied because they feared the disease and saw
screening as routine care, but other women feared medical examinations,
healthcare providers, tests and procedures and didn’t seek screening if
their health was good.
“Lack of information was a big barrier. It was clear from our review
that very few women understood that cervical smear testing aims to
identify abnormal cells before they become malignant and that breast
screening can detect cancer in the early stages when treatment is most
“The review also highlighted that many women had misconceptions about
breast and cervical cancer and who was at risk. For example, some women
felt they did not need breast or cervical screening after a certain age
and some believed that they could not develop cervical cancer if they
weren’t in a current sexual relationship.
“Women who did not have a family history of cancer were also less
likely to think they were at risk. Because there has been a lot of
publicity about the role that family history can play in breast cancer,
many women assumed wrongly that the same family patterns can apply to
Figures from the USA and UK show that there is a big gap between the
number of women invited for screening and the number who actually
In 2007 the Centers for Disease Control and Prevention in America
estimated that 25% of women aged 40 plus had not had breast screening in
the last two years and 16% aged 18 and over had not had a cervical smear
in the last three years.
Cancer Research UK figures for the same year suggest that 4.4 million
women were invited for cervical smears but only 3.6 million (82%)
Breast cancer rates are similar in both countries, despite
differently funded healthcare systems and screening criteria, but a
lower percentage of UK women die from cervical cancer.
The researchers have come up with three key recommendations as a
result of their review:
- Nurses should promote screening by educating women of the
benefits of breast and cervical screening even when they do not ask
- Initiatives aimed at increasing uptake rates should focus
on women’s fears about the procedure or a possible positive result.
- Public health messages need to specifically target women
who do have access to healthcare but fail to undergo routine
“Nurses have a key role to play in addressing the fears and lack of
knowledge that women have when it comes to screening for breast and
cervical cancer,” concludes Dr Ackerson.
“They need to help women understand both the risks and benefits of
screening so that they can make informed choices about whether or not
they want to be tested.”
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