Toolkit for engaging Under-screened and Never-screened women in the National Cervical Screening Program

Barriers to screening

Page last updated: 31 October 2020 (this page is generated automatically and reflects updates to other content within the website)

There are many potential barriers that may influence a woman in her decision or ability to participate in cervical screening. Studies into barriers have typically focused on barriers to having a Pap test. Barriers may be related to the patient, healthcare provider or the health system.

Patient-related barriers

Emotional / cultural

Lack of knowledge about -

Personal relevance


Embarrassment about the procedure

The purpose of a Cervical Screening Test

Not believing cervical cancer is a risk

Time constraints, including availability of child care

Fear - of tests, of being diagnosed with cancer, of further tests or of cancer treatment

The role of screening in prevention

Not considering screening to be a priority

Intending to have a test, but not getting around to doing it or forgetting when the test is due

Reluctance to screen after a negative past experience such as previous pain or discomfort

The risks of cervical cancer

Limited previous experience of prevention or screening programs

Concerns about cost

Past history of sexual abuse or sexual violence

Who needs to be tested

Being asymptomatic

Language issues

Confidentiality concerns

The accuracy of the test

Perception that HPV vaccinated women do not require screening

Lack of transport

Cultural issues (related to circumstances, beliefs, background and inequities in society)

Cancer and/or a belief that cancer = death

Perception that screening is not required for women who have sex with women, or for transgender men

Physical, social or practical barriers associated with a disability




Weight-related barriers (obesity)




Personal preference for choice of healthcare provider

Healthcare provider and system-related barriers

Healthcare provider-related barriers

System-related barriers

Time constraints and pressure to restrict consultation times

Accessibility of the health service

Availability of female healthcare providers

Availability of convenient appointment times

Lack of practical training in cervical screening (e.g. for international medical graduates who have never performed cervical screening)

Availability of bulk billing

The patient knowing the healthcare provider personally

Services without a culturally sensitive environment

Interpersonal and communication skills

Availability of female healthcare providers or any healthcare provider who is a cervical screener

Age and/or cultural background of the healthcare provider

Availability of local  language resources and patient information