"Hvad hvis jeg er mega bange?" - Et speciale i kommunikations betydning for unge kvinders stillingtagen til deltagelse i screening for livmoderhalskræft

Abstract

The aim of this master’s thesis is to explore how discourses regarding cervical cancer and the smear test affects the decision-making to participate in the screening program among young Danish women. It further examines how health communication, particularly from the interest group Kræftens Bekæmpelse, contributes to dismantling barriers that limits participation in the screening. Despite the fact that cervical cancer is highly preventable through HPV vaccination and regular screening, the participation rate among young Danish women remains low. Furthermore, the study employs a social constructivist and discourse psychological framework, drawing on empirical data from three focus group interviews with young women aged 20 to 28. The analysis demonstrates that women’s engagement with screening is shaped less by informational access and reminders and more by the interplay of discourses, affect, social norms, and cultural imaginaries. Communication is not merely a matter of transmitting information, but a process of meaning-making that shapes women’s understanding and behaviour. Psychological barriers, such as cancer fear, stigma caused by intimacy and lack of knowledge, and perceptions of screening as irrelevant, emerge as significant barriers towards screening. Additionally, social barriers, such as the absence of dialogue, the doctor’s role as a gatekeeper, and insufficient assumption of personal health responsibility, are shown to be highly influential. The thesis there-by demonstrates that health communication risks losing impact when it simplifies or disregards the complexity of women’s decision-making. Health campaigns tend to rely on paternalistic messages, often provoking the women rather than supporting an informed decision-making. The analysis further suggests that fear appeals and judgmental narratives such as the campaign title Er der noget, du har glemt? stigmatizing non-participants can be seen as counterproductive, and risk further marginalizing women who already experience anxiety related to health topics and behaviour. Drawing on existing research and the empirical findings, the thesis argues that future health communication and campaigns should be more targeted and nuanced. It recommends that health organizations tailor messages to the needs and preferences of differentiated audiences, employ trust-building language, and strategically use digital platforms and influencers based on young women’s patterns of media consumption, preferences and digital practices. Communication that acknowledges the diverse barriers that women face and offers support rather than pressure is more likely to encourage participation while respecting women’s autonomy. Overall, this thesis contributes with valuable insights into how health communication can be more inclusive and effective to the prevention of cervical cancer, with the overarching goal of increasing the participation in screening and advancing the World Health Organization’s goal of eliminating cervical cancer as a public health issue. Despite this, it is necessary to acknowledge that segments of the population may remain beyond the reach of even the most comprehensive health communication efforts. While challenges remain in reaching every Danish woman, this thesis provides a foundation for developing more inclusive and impactful communication approaches.

A master thesis from Aalborg University

"Hvad hvis jeg er mega bange?" - Et speciale i kommunikations betydning for unge kvinders stillingtagen til deltagelse i screening for livmoderhalskræft

["What if I'm really scared?" - A master's thesis on the significance of communication in the decision-making of young women regarding participation in cervical cancer screening]