Women’s preferences for cervical cancer screening methods: a discrete choice experiment in Estonia and France

Violette Delisle, Lise Rochaix (), Marc Bardou, Anneli Uusküla, Anna Tisler and Carine Franc ()
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Violette Delisle: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris - AP-HP - Hôpital Paul Brousse - AP-HP - Assistance publique - Hôpitaux de Paris - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay
Lise Rochaix: PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris
Marc Bardou: CIC1432 - Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie - Direction Générale de l'Organisation des Soins (DGOS) - INSERM - Institut National de la Santé et de la Recherche Médicale - UBE - Université Bourgogne Europe
Anneli Uusküla: Tartu Ülikool = University of Tartu [Estonie]
Anna Tisler: Tartu Ülikool = University of Tartu [Estonie]
Carine Franc: CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris - AP-HP - Hôpital Paul Brousse - AP-HP - Assistance publique - Hôpitaux de Paris - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay

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Abstract: Background This study explores women's preferences for cervical cancer screening (CCS) in Estonia and France, particularly preferences for self-sampling (SS). Although many European countries have introduced organized CCS, screening behaviours still exhibit a strong social gradient, with CC disproportionately affecting populations facing barriers to access, such as low income, rural residence, migration status or low education. The WHO has set a goal of eliminating CC and has proposed different strategies of invitations, outreach campaigns and the introduction of SS as a potential lever to increase uptake. Methods To assess whether these CCS strategies align with women's preferences, we conducted a discrete choice experiment (DCE) in Estonia and France. Pooling our data (N = 4774), we used a two-stage decision-making framework; first, intervention preferences were assessed, and then the willingness to participate if preferred interventions were implemented was measured. We also conducted a heterogeneity analysis via latent class analysis. The DCE has three attributes: invitation methods, sampling methods (physician-based sampling or self-sampling), and awareness-raising campaigns. The results were analysed using a mixed multinomial logit model to capture heterogeneity in preferences and explore factors influencing CCS participation. Results The results show that the implementation of SS would: 1) increase uptake among women facing geographical barriers to CCS, 2) help engage first-time screeners in a screening pathway and 3) possibly deter participation from women already engaged in their screening pathway if implemented as sole mean of screening. Conclusions Our results thus advocate for tailored screening programs.

Date: 2026-04
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Published in BMC Women's Health, 2026, 26 (1), ⟨10.1186/s12905-026-04478-z⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:pseptp:halshs-05845470

DOI: 10.1186/s12905-026-04478-z

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