Format

Send to

Choose Destination
Soc Sci Med. 2017 Jun;183:48-55. doi: 10.1016/j.socscimed.2017.04.040. Epub 2017 Apr 26.

Controversies about cervical cancer screening: A qualitative study of Roma women's (non)participation in cervical cancer screening in Romania.

Author information

1
Cancer Registry of Norway, Oslo, Norway; Institute of Health and Society, University of Oslo, Norway. Electronic address: trude.andreassen@kreftregisteret.no.
2
Cancer Registry of Norway, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
3
The Oncology Institute "Prof. Dr. Ion Chiricuţă" of Cluj-Napoca, Romania.
4
The Oncology Institute "Prof. Dr. Ion Chiricuţă" of Cluj-Napoca, Romania; "Iuliu Haţieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania.
5
"Iuliu Haţieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania.
6
Cancer Registry of Norway, Oslo, Norway; Institute of Basic Medical Sciences, University of Oslo, Norway.
7
Institute of Health and Society, University of Oslo, Norway.

Abstract

Romania has Europe's highest incidence and mortality of cervical cancer. While a free national cervical cancer-screening programme has been in operation since 2012, participation in the programme is low, particularly in minority populations. The aim of this study was to explore Roma women's (non)participation in the programme from women's own perspectives and those of healthcare providers and policy makers. We carried out fieldwork for a period of 125 days in 2015/16 involving 144 study participants in Cluj and Bucharest counties. Fieldwork entailed participant observation, qualitative interviewing and focus group discussions. A striking finding was that screening providers and Roma women had highly different takes on the national screening programme. We identified four fundamental questions about which there was considerable disagreement between them: whether a free national screening programme existed in the first place, whether Roma women were meant to be included in the programme if it did, whether Roma women wanted to take part in screening, and to what degree screening participation would really benefit women's health. On the background of insights from actor-network theory, the article discusses to what degree the programme could be said to speak to the interest of its intended Roma public, and considers the controversies in light of the literature on patient centred care and user involvement in health care. The paper contributes to the understanding of the health and health-related circumstances of the largest minority in Europe. It also problematizes the use of the concept of "barriers" in research into participation in cancer screening, and exemplifies how user involvement can potentially help transform and improve screening programmes.

KEYWORDS:

Cervical cancer; Cervical cancer-screening; Controversies; Interessement; Participation; Roma; Romania; User involvement

PMID:
28460211
DOI:
10.1016/j.socscimed.2017.04.040
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science Icon for Norwegian BIBSYS system
Loading ...
Support Center