Investigating the decrease in participation in the Dutch cervical cancer screening programme: The role of personal and organisational characteristics

• Participation in the Dutch cervical cancer screening programme declined recent years. Higher attendance rates were observed women who invited by their GP. Differences personal characteristics did not explain decline rates. Adjusting for inviting organisation (i.e. GP or SO) explained some differences attendance. Declining was recently observed, coinciding with preparations implementing primary hrHPV-based screening, which implemented January 2017. We aimed to investigate factors related decreased conducted a population-based cohort study including all aged 30 60 years eligible between 2014 and 2018. Attendance defined as participation within 15 months of start invitation-eligible year. used data from pathology archive (PALGA) linked Statistics Netherlands population (position household, household income, socio-economic status, number people migration background, age) five organisations (SO) effect cessing self-inviting GP’s (‘inviting organisation’). SO’s termed SO 1 5. employed (60.8%), married (62.9%), (61.2%), highest income bracket (63.4%), living households four persons (65.3%) (69.8%). By adjusting whether sent invitation, 2015 2016 2017–2018 organisations. Removing possibility GPs send invitations explains participation, although this account total change