Challenges in encouraging and maintaining participation in cervical cancer screening programmes in Romania and Norway
AbstractWomen from the Roma population have very low participation rate in Romania's national cervical cancer screening programme. Romania has at the same time Europe's highest incidence and mortality rates of cervical cancer. In Norway the participation rate to the national screening programme is high while the incidence and mortality rates of cervical cancer are low. It was, however, unknown if the introduction of human papillomavirus (HPV) testing would lead to increased anxiety and depression and if screening participation would decrease due to mental distress. In the dissertation Challenges in encouraging and maintaining participation in cervical cancer screening programs in Romania and Norway, Trude Andreassen and colleagues have examined screening participation in two different European countries. In Romania they found that there had been little interaction between those who offered screening and the targeted women. Despite the existence of a free-of-charge screening program, many Roma women were unaware of its existence, that it included them, and that participation could improve their health. Participation was not associated with ethnicity, but with the number of sexual partners, knowing about the screening opportunity and living in urban areas. The essence of the study shows the importance of user involvement in the planning, mobilization and implementation of the programme, aiming to build trust between those offering screening and the potential participants. In Norway, they found that women who were screened with HPV did not experience increased anxiety and depression as compared to women screened with the conventional cell-sample. Nor was the severity of the screening results different in relation to anxiety and depression scores between women screened with cell-sample or HPV testing. Based on the findings of the study it is concluded that there is no reason to assume that HPV testing will lead to reduced attendance to screening based on anxiety and depression.
List of papers
|Paper I: Andreassen, T., Weiderpass, E., Nicula, F., Şuteu, O., Itu, A., Bumbu, M., Tincu, A., Ursin, G., & Moen, K. (2017). Controversies about cervical cancer screening: A qualitative study of Roma women’s (non)participation in cervical cancer screening in Romania. Social Science & Medicine, 183, 48-55. The published version of this article is included in the thesis. Also available in DUO at: http://urn.nb.no/URN:NBN:no-63743|
|Paper II: Andreassen, T., Melnic, A., Figueiredo, R., Moen, K., Şuteu, O., Nicula, F., Ursin, G., & Weiderpass, E. (2018). Attendance to cervical cancer screening among Roma and non-Roma women living in North-Western region of Romania. International Journal of Public Health, 63, 609–619. The published version of this article is included in the thesis. Also available at: https://doi.org/10.1007/s00038-018-1107-5|
|Paper III: Andreassen, T., Hansen, B.T., Engesæter, B., Hashim, D., Støer, N., Tropè, T., Moen, K., Ursin, G., & Weiderpass, E. (2018 Dec 14). Psychological effect of cervical cancer screening when changing primary screening method from cytology to hrHPV testing. International Journal of Cancer. The published version of this article is included in the thesis. Also available at: https://doi.org/10.1002/ijc.32067|