BD (Becton, Dickinson and Company) announced the results of a Harris Poll survey of women in the U.S., U.K. and Sweden, which shines a spotlight on the differences in access to cervical cancer screening and prevention.
Most women in these countries have delayed a gynecology visit (67% U.S., 62% Sweden, 59% U.K.), primarily due to discomfort with pelvic exams (28% U.S., 38% Sweden) or embarrassment (33% U.K.). Notably, U.S. women are about twice as likely to say they have delayed a gynecology visit because they didn't have an OB/GYN (27% U.S. vs. 16% Sweden, 14% U.K.) or insurance coverage (19% U.S. vs. 8% U.K., 3% Sweden). These results highlight that health equity in the U.S. is lacking, with just 60% of U.S. women reporting that health care in the U.S. provides equal access to all racial and ethnic groups (compared to 79% in Sweden and 76% in the U.K.).
Self-collection for cervical cancer screening is a viable option for increasing access and health equity. It is already available in countries around the world, including Denmark, Sweden, the Netherlands, Kenya, Australia and New Zealand. The study found that the majority of women say they would be comfortable doing a self-collected vaginal test at home to screen for cervical cancer (65% Sweden, 63% U.K., 56% U.S.) and most women (70% U.K., 69% Sweden and 66% U.S.) would be interested in at-home screening for HPV or cervical cancer. Reasons given include being more comfortable in the privacy of their own home, having the ability to administer the test themselves (without a doctor) and not having to make time through an appointment to see a health care practitioner. Notably, younger women are more likely to be interested in self-collection across all three geographies surveyed.
When asked why they might be interested in at-home screening for HPV or cervical cancer, of those interested, women in the U.S. – a country where self-collection is not available -- are twice as likely as women in European countries to want to self-collect at home because it might be less expensive (42% U.S. vs. 25% Sweden, 15% U.K.).
Women in the U.K. are more likely to say they are knowledgeable about how often women their age should be screened for cervical cancer (70% vs. 59% US and 44% Sweden), yet the survey found that 36% of U.K. women incorrectly believe that women aged 30-65 need a cervical screening test every year. This awareness gap is more strongly present in the U.S., with 61% whose understanding is incorrect. (In the U.S., the American Cancer Society recommends HPV primary screening for cervical cancer every five years for women aged 25-65.)
Additionally, 73% of Swedish women, 59% of U.S. women and 46% of U.K. women mistakenly believe that Pap (Papanicolaou) tests are the most accurate test for detecting cervical cancer. Most women in the U.S. (65%) know that some types of HPV put women at a higher risk for developing cervical cancer than others, but less than half of U.S. women (49%) recognize that certain ethnicities are more negatively affected by cervical cancer and pre-cancer than others.
The results showed that most women consider cervical cancer screening a critical part of their health management (86% Sweden, 81% U.K., 76% U.S.). However, many women find the guidance on cervical cancer screening confusing (59% Sweden, 57% U.S., 55% U.K.) and do not understand the difference between a Pap test and an HPV test, despite the fact that HPV is the cause of virtually all cervical cancers. Additionally, women's knowledge about cervical cancer and HPV is lacking, especially in Sweden where only 28% of women consider themselves knowledgeable about cervical cancer screening options, versus 62% of women in U.K. and 59% of women in the U.S.
This survey was conducted online by The Harris Poll among 1,112 U.S. women ages 18+ (Nov. 17-21, 2023); 506 women ages 18+ residing in the U.K. (Nov. 21-23, 2023); and 520 women ages 18+ residing in Sweden (Nov. 22-25, 2023). The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data is accurate to within +/- 2.7 percentage points using a 95% confidence level for the U.S. sample, +/- 3.3 percentage points for the U.K. sample, and +/- 3.7 percentage points for the Swedish sample.
