Family physicians' barriers to cervical cancer screening in women aged from 50 to 65 years

Summary Aim: The Pap-test coverage rate for cervical cancer screening is estimated at 57%, far below the public health target of 80%. This may even be less than 50% in women over 55 years. This study aimed to identify barriers to cervical cancer screening in women aged 50 to 65 years in general practice, a necessary step before the development of corrective actions. Methods: Peer support groups of GPs working in Rhone-Alpes were interviewed using the method of focus groups until data saturation was reached. GPs were selected to form a heterogeneous sample in terms of demographic characteristics and gynecological practice. Results: Four focus groups allowed to interview five women and seventeen men aged 36 to 63 years. Many barriers to screening were raised: they were related to the patient (ignorance, fear, economic or social brakes), to the doctor himself (doubt about the benefit, ignorance of the age of stop, technical difficulties, lack of interest for pap smears, omission) or to doctor-patient relationship (embarrassment, lack of availability or weak therapeutic alliance). Health system organization, including method of remuneration, also played a role. Conclusion: Beyond barriers to screening, this qualitative study helps to identify ways for improving the Pap smear screening coverage: organization of screening, better information for patients and physicians, enhanced value given to preventive actions and involvement of other health professionals. Prat Organ Soins. 2012;43(4):261-268