‘I do not need to… I do not want to… I do not give it priority…’– why women choose not to attend cervical cancer screening

OBJECTIVE: To describe and interpret why women with no cervical smear taken during the previous 5 years choose not to attend a cervical cancer screening (CCS) programme. BACKGROUND: CCS programme is a service for early detection of cervical cancer. Today, some women choose not to attend the programme. DESIGN: Data were collected by tape-recorded interviews and analysed by qualitative inductive content analysis. SETTING AND PARTICIPANTS: Purposive sample of 14 women in southeast Sweden, who had chosen not to attend CCS during the previous 5 years. FINDINGS: The following themes were revealed: I do not need to..., I do not want to... and I do not give it priority.... The women had a positive attitude to CCS but as long as they felt healthy, they chose not to attend. A negative body image, low self-esteem, feelings of discomfort when confronted with the gynaecological examination and fear of the results also influenced their non-attendance. The women prioritized more important things in life and reported various degrees of lack of trust in health-care. CONCLUSION: Women's choice not to attend CCS were complex and influenced by present and earlier intra- and inter-personal circumstances. They had a positive attitude to CCS, but other things in life were more important. Health-care professionals have to facilitate a co-operative discussion with the women in order to contribute to a mutual understanding for the perspectives of the women and the professionals.