Perspective of pregnant women on feasibility of integrating cervical cancer screening into antenatal care in the Netherlands: a questionnaire study.

Background: Dutch programmed cervical cancer screening starts at the age of 30, but efficacy is hampered due to low uptake, especially among youngest invitees aged 30-40 (< 50%). Currently, pregnant women are excluded from screening, but we hypothesize that participation could be increased if screening would be discussed routinely during obstetric care, motivating unscreened women to attend. Via this questionnaire study, we aimed to assess whether pregnant women in the Netherlands considered such "antenatal screening" acceptable.

Methods: In 2021 and 2022, a single written questionnaire was provided to pregnant women aged 30 years or older, undergoing obstetric care in the Rotterdam region, the Netherlands. Women were asked about previous screening attendance and perceived feasibility of antenatal screening, including benefits and harms. Primary outcome was the percentage of women considering antenatal screening feasible. Secondary outcomes included considered benefits and harms of antenatal screening and differences between adequately screened and un-/under screened women.

Results: In total, 372 out of 1511 (24.6%) returned the questionnaire. Among respondents 106 of 372 (28.5%) were un-/under screened. Of all responders, 78% considered introduction of antenatal screening a good idea, without difference among adequately screened (78.9%) vs un-/under screened women (75%; P = .25). Benefits of antenatal screening considered most by respondents were a feeling of reassurance (58.5%) and easier scheduling (37.0%).

Conclusions: Introduction of cervical cancer screening via obstetric care is considered acceptable by a majority of pregnant women in the Netherlands. Benefits considered most were a feeling of reassurance and easier scheduling of attendance.