Well-organised cervical screening is effective in reducing cervical cancer incidence and mortality. To achieve these benefits, high coverage is essential. In Ireland, the coverage target is 80%. While overall coverage has risen (from 61% to 79%) since the programme started in 2008, it has consistently been lower in older (50-60 years) than younger (25-49 years) women. This distinctive pattern is not seen in other countries with organised programmes and the reasons for it are unknown. Women in their early 50s are at risk of developing cervical cancer and screening at that age substantially reduces cancer risk for the subsequent 30 years. Thus, it is important to attain high screening coverage in older women.
This CERVIVA-CervicalCheck co-production project will generate evidence on the influences on cervical screening participation among older women in Ireland, to inform development and implementation of evidence-based strategies to increase screening coverage in this group.
A mixed-methods design will be used, underpinned by a theoretical framework of behaviour change. Phase 1 will involve in-depth interviews exploring influences on, barriers to, and enablers of, cervical screening participation; older and younger women and women with adequate and inadequate screening histories will be compared. Phase 2 will involve a postal survey of older women, comparing those with adequate and inadequate screening histories, to identify the most important influences on screening participation and inter-relationships between these. Phase 3 will triangulate phase 1 and 2 results and undertake a behavioural analysis to begin to generate evidence-based solutions for how screening participation may be changed. The findings will be translated by the National Screening Service into strategies to improve participation in older women, thereby optimising effectiveness of cervical screening in Ireland and delivering health gains for individual women and the population. The knowledge gained may also be applicable to other screening programmes in Ireland.
