The UK NHS cervical screening information leaflet: discourse, purpose and potential for change

Background: Cervical cancer screening prevents unnecessary deaths, yet rates of attendance have been dropping in the United Kingdom. Leaflets communicate screening information in invites to everyone eligible to attend. However, these information leaflets are known to be hard to understand and inaccessible. Aim: To understand how cervical screening is constructed in information leaflets and how this might impact engagement with screening programmes. Method: Discourse analysis of the current UK information leaflet, and a version redesigned with a public and patient involvement group. Result: The current leaflet uses discourses of neutrality and patient autonomy, with design akin to scientific texts. The redesigned leaflet presents a simplified, step-by-step guide to screening that aims to motivate and persuade readers. Discussion: The current information leaflet positions intended audiences as rational agents who have responsibility to make a choice to attend screening based on scientific information. The public’s redesign positions the state as responsible for simplifying and convincing people to attend screening. The disjuncture may be due to different underlying ideologies – neoliberalism versus ‘welfarism’. Conclusion: Shifting the current discourse to simplified and clearer language which emphasises choice in the process could help people make an informed decision to engage in screening.