Cognition and affect after cervical screening: The role of previous test outcome and personal obligation in future uptake expectations

276 women aged 20 to 60 years who had recently undergone the cervical smear test for detection of cervical abnormalities were interviewed concerning their experiences at screening, the screening test and their future screening expectations. The vast majority of women indicated that it was very likely they would undergo future tests, in spite of recently publicised concerns about negative impacts of positive results. The analysis further demonstrated that future screening expectations were best explained not by appraisals of disease threat, but by a sense of obligation to attend and by perceptions of the aversiveness of the test procedure. Women who reported that their last test had been painful or embarrassing held more negative views of a future test, but a prior positive result was not implicated in women's expectations concerning future screening. Social class was associated with future uptake expectations, even amongst this sample of women who had already undergone the test. Multivariate analysis showed that the effects of social class on expectations concerning future participation in screening was explained by the tendency of lower class women to view the test as aversive and to feel less personal obligation to attend.