Using Social Media to Increase Cervical Cancer Screening Attendance Among Younger Women - The Annual #sjekkdeg

Key Contextual Factors

• The #sjekkdeg campaign is not based upon any legal frameworks.
• The responsibility to continue the campaign is shared between the Norwegian Cancer Society and Cancer Registry of Norway
• Other involved are: GPs offices, Gynecologists offices, The Norwegian public press, Social media platforms, Det Nye – a magazine for young women, Thea Steen Foundation.
• The campaign was partly based on sale of clothes from popular fashion stores for women and possibility to get free coffee from the coffee shops. Profits as well as private donations, contribute to Thea Steen Foundation, which are used by the Norwegian Cancer Society in work to prevent cervical cancer among young women through the #sjekkdeg campaign.

Key Components/Steps

First campaign rolled out in September 2015, thereafter annually in September

• 2015: Young female Norwegian celebrities are featuring short campaign films encouraging women to take a pap smear, influencers tag their social profiles and blogs with the campaign logo, #sjekkdeg Facebook frame, the magazine Det Nye publishes several texts to promote the campaign, broad press and media coverage.
• 2016: Start of the Foundation in memory of Thea Steen; volunteer health workers take pap smears; coffee served in the #sjekkdeg cups.
• 2017: Gynecology clinics offer free screening; TV2 produces a documentary film about Thea Steen and her fight against cancer
• 2018: Clothing campaign by youngsters’ brand BikBok; massive sharing of the campaign message in social media, on the screens at gym-studios and doctor-offices; campaign at local hospitals for employees to take a smear; the GPs join the campaign providing smears free of charge.
• 2019: Famous social-media doctor and a female influencer make a movie of her cervical screening examination; information meetings for immigrants in their native languages arranged throughout Norway.
• 2020: The app Tise, for Second-hand shopping, joins the campaign with the message to lesbian and Sami women; #sjekkdeg enters Instagram platform.

Main Impacts / Added Value

• By attending the screening program, women are systematically screened and cellular changes are detected at an early stage. Early detection of precancerous lesions and treatment of these may prevent development of cancer. Treatment of precancerous lesions is less invasive and destructive than treatment of cancer. The success rate for treatment of precancerous lesions are higher than for cancer.
• More lives saved, and saved costs.
• The coverage among women 25-29 years increased from 55,7% to 64,2 % from 2013 to 2019. The corresponding numbers were 66,3% to 70,2% for women in the whole screening age group 25-69 years of age.  The raised awareness of cervical cancer has thought to contribute to increased attendance to the cervical cancer screening program since 2015.

Lessons Learned

• Unconventional thinking can be useful when it comes to reaching a targeted audience with health-related campaigns. In modern society, the flow of information is massive, particularly within new social media platforms. Within these platforms, influencers can have more power than health providers and authorities. It is therefore important that health providers and authorities support and acknowledge the work of influencers, and continuously fill the enormous demand for knowledge with evidence-based data to prevent misinformation and misunderstanding.
• To engage young women in cancer screening program is challenging as the cancer is not perceived as a disease which is relevant for this age group. #sjekkdeg campaign improved the knowledge and increased the demand for screening services among young women.

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