Cervical screening saves about 4,500 lives every year
Practical reasons could be more significant than emotional ones in explaining why many women miss cervical cancer screenings, a study suggests.
It had been thought emotional factors - such as embarrassment or fear - were largely to blame for low take-up rates.
But a Journal of Medical Screening study found women who said they rarely or never voted in elections were more likely to be overdue for screening.
And researchers say the women could simply be too busy for either activity.
The team, from the charity Cancer Research UK, found the association was strongest in women aged 26-44.
Cervical screening saves about 4,500 lives every year.
Researcher Dr Jo Waller said: "With uptake of cervical screening in England still much lower than we would like, these findings suggest that overcoming practical barriers may be the most important factor in maximising cervical screening uptake.
"These results are encouraging. In the past, it was thought that emotional factors such as concern about embarrassment and pain were the best predictors. Minimising practical difficulties is a more achievable goal.
"In terms of the correlation between voting and screening attendance, it may be that as both activities require a degree of organisation, women who do not manage to vote because of busy lives may also be unlikely to attend screening."
The researchers suggest that measures to minimise practical difficulties, such as evening and weekend clinics, could have a significant effect.
A separate US study, published in the same journal, suggests the more children living in a household, the lower the cancer screening attendance in adults from that household.
The researchers suggest that parents could have less time to attend screenings and prioritise the needs of their children above their own.
Professor Julietta Patnick, director of the NHS Cancer Screening programmes, said: "We have been concerned for some time about falling acceptance rates for screening, particularly amongst certain groups in society, such as women under 35 and the over 55s.
"This study helps us understand what the issue might be and will be useful for us in addressing the issues."