UICC World Cancer Congress 2006

Objective: The aim of this study was to analyze the differences in determinants of (non-) attendance between women of high and low socioeconomic status to the Dutch cervical cancer-screening program.

Methods: Attendees and non-attendees of the screening program in 2001 (n=200), aged 30 to 60, were selected from a larger sample of women residing in Limburg, the Netherlands. A computer assisted telephonic survey based on the I-Change Model was used to collect data on determinants of (non) participation. Differences between women of high and low socioeconomic status were analyzed. Women with no more education than secondary school were defined as having a relatively low socioeconomic status (LSES), whereas women with a higher level of education were defined as high socioeconomic status women (HSES).

Results: HSES women knew significantly more about inclusion criteria for screening, potentials of screening and need for screening. No differences in risk perception were found. LSES women experienced significantly more affective disadvantages of screening. They were more insecure of smear taking, expected to experience more feelings of shame and embarrassment during smear taking and were more insecure and anxious about the result of screening. HSES-women felt more at ease at the doctors' office and were more confident about the healthy condition of their cervix. More HSES women attended the screening program in 2001 compared to LSES women. The most striking outcome of this study, the importance of perceived emotional disadvantages of LSES women, suggests that partially differential factors determine participation in cervical screening programs for HSES and LSES women.