barriers and facilitating factors for cervical cancer screening: a qualitative study from iran

background: this study aimed to explore the experiences of iranian women regarding the barriers to and facilitating factors for cervical cancer screening. methods: eight focus groups (n= 86 participants) were conducted with women referred to a health center in karaj, iran from january to march, 2007. purposeful sampling was used. married women aged 18 years old and over, not suffering from obstetrics/ gynecological disease during last two years and being willing to participate in the study were included. framework analysis was used to extract the themes from the data. results: in general, the participants stated that they were not knowledgeable regarding cervical cancer. moreover, most of the participants had negative beliefs regarding cancer prevention, including lack of free time to do the test, cost of the test, no symptoms cue. the perceived facilitating factors verified by the participants were cues to action, health care motivator, and perceived threat. conclusion: the findings of this study revealed that there are various psychosocial barriers to cervical cancer screening among iranian women. high accessibility and availably of the test as well as health care providers' encouragements may improve the rate of cervical cancer screening. keywords: cervical cancer; pap smear; screening; practice references 1. claeys p, gonzalez c, gonzalez m, page h, bello r, tammerman m. determinants of cervical cancer screening in a poor area: results of a population – based survey in rivas, nicaragua. tropical medicine and international health. 2002; 7(11):935-41. 2. ho v, yamal j, atkinson e, basen-engquist k, tortolero-luna g, follen m. predictors of breast and cervical screening in vietnamese women in harris county, houston, texas. cancer nursing 2005; 28(2):119-29. 3. ferlay j, bray f, pisani p, parkin d. cancer incidence, mortality, and prevalence worldwide. lyon, france: iarc press; 2004. 4. announcement the society of gynecologic oncologists’ statement on a cervix cancer vaccine. gynecol oncol 2006; 10:377. 5. national cancer registry report [compact disk]. tehran: islamic republic of iran ministry of health and medical education, deputy of health feb, 2005. 6. behtash n, karimizarchi m. cervical cancer: the preventive role of hpv vaccine. tehran university medical journal 2007; 64(12):1-8. 7. dastranj a, alizadeh m, sayyah m, jafari m, madarek e. incidence rate of cervical cancer and precancerous lesions in east azarbayjan, iran. asia–pacific journal of clinical oncology. 2006; 2:87-90. 8. kumar v, abbas a, fausto n, mitchell r, robbins. basic pathology. 8th ed. philadelphia: w.b. saunders 2007. 9. chirenje z, rusakaniko s, kirumbi l, ngwalle e, makuta–tlebere p, kaggwa s, et al. situation analysis for cervical cancer diagnosis and treatment in east, central and southern african countries. bulletin of the world health organization 2001; 79:127-32. 10. sankaranarayanan r, budukh a, rajkumar r. effective screening programs for cervical cancer in low- and middle-income developing countries. bulletin of the world health organization. 2001; 79:954-62. 11. bingham a, bishop a, coffey p, et al. factors affecting utilization of cervical cancer prevention services in low-resource settings. salud pública de méxico. 2003; 45(2):s283-s91. 12. kuzel aj. sampling in qualitative inquiry. in: w.l. miller, ed. doing qualitative research. thousand oaks: ca: sage 1992:31-44. 13. lee m. knowledge, barriers, and motivators related to cervical cancer screening among korean-american women. cancer nursing, an international journal for cancer care. 2000; 23(3):168-75. 14. ritchie j, spencer l. qualitative data analysis for applied policy research. in: bryman a, burgess r, eds. analysing qualitative data. london: routledge 1994:173-94. 15. champion v, skinner c. the health belief model. in: glanz k, rimer b, viswanath k, eds. health behavior and health education: theory, research, and practice. san francisco: calif: jossey-bass 2008:45-62. 16. miles m, huberman a. qualitative data analysis: an expanded sourcebook. 2nd ed. thousand oaks, ca: sage 1994. 17. barbour r. checklists for improving rigour in qualitative research: a case of the tail wagging the dog?. british medical journal 2001; 322:1115-7. 18. pope c, ziebland s, mays n. analysing qualitative data. british medical journal. 2000; 320:114-6. 19. lee e, tripp-reimer t, miller a, sadler g, lee s. korean american women’s beliefs about breast and cervical cancer and associated symbolic meanings. oncology nursing forum. 2007; 34(3). 20. ashing k, padilla g, tejero j, kagawa-singer m. understanding the breast cancer experience of asian american women. psycho- oncology. 2003; 12(1):38-58. 21. baron-epel o, granot m, badarna s, avrami s. perceptions of breast cancer among arab israeli women. women and health. 2004; 40:101-16. 22. peters r, bear m, thomas d. barriers to screening for cancer of the cervix. prev med. 1989; 18:133-46.