Acceptability of extending HPV-based cervical screening intervals from 3 to 5 years: an interview study with women in England.

Martin Nemec, Jo Waller, Jessica Barnes, Laura A V Marlow
Author Information
  1. Martin Nemec: Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK. ORCID
  2. Jo Waller: Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK. ORCID
  3. Jessica Barnes: Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
  4. Laura A V Marlow: Cancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK l.marlow@kcl.ac.uk. ORCID

Abstract

OBJECTIVES: The introduction of primary Human Papillomavirus (HPV) testing in the National Health Service (NHS) Cervical Screening Programme in England means the screening interval for 25-49 years can be extended from 3 to 5 years. We explored women's responses to the proposed interval extension.
METHODS: We conducted semi-structured phone/video interviews with 22 women aged 25-49 years. Participants were selected to vary in age, socioeconomics and screening history. We explored attitudes to the current 3-year interval, then acceptability of a 5-year interval. Interviews were transcribed verbatim and analysed using framework analysis.
RESULTS: Attitudes to the current 3-year interval varied; some wanted more frequent screening, believing cancer develops quickly. Some participants worried about the proposed change; others trusted it was evidence based. Frequent questions concerned the rationale and safety of longer intervals, speed of cancer development, the possibility of HPV being missed or cell changes occurring between screens. Many participants felt reassured when the interval change was explained alongside the move to HPV primary screening, of which most had previously been unaware.
CONCLUSIONS: Communication of the interval change should be done in the context of broader information about HPV primary screening, emphasising that people who test negative for HPV are at lower risk of cell changes so can safely be screened every 5 years. The long time needed for HPV to develop into cervical cancer provides reassurance about safety, but it is important to be transparent that no screening test is perfect.

Keywords

References

  1. BMC Public Health. 2016 Mar 02;16:213 [PMID: 26935960]
  2. Psychol Health. 2010 Dec;25(10):1229-45 [PMID: 20204937]
  3. J Med Screen. 2021 Sep;28(3):333-340 [PMID: 33175638]
  4. JMIR Cancer. 2019 Apr 11;5(1):e12307 [PMID: 30973340]
  5. Prev Med Rep. 2020 Nov 28;20:101268 [PMID: 33318889]
  6. BMC Health Serv Res. 2017 Jan 26;17(1):88 [PMID: 28126032]
  7. Int J Qual Health Care. 2007 Dec;19(6):349-57 [PMID: 17872937]
  8. Prev Med. 2019 Feb;119:108-117 [PMID: 30594536]
  9. Obstet Gynecol. 2015 Feb;125(2):317-329 [PMID: 25568994]
  10. Br J Health Psychol. 2018 Sep;23(3):519-531 [PMID: 29453791]
  11. Patient Educ Couns. 2022 Aug;105(8):2757-2762 [PMID: 35440375]
  12. BMJ Open. 2018 Feb 13;8(2):e019171 [PMID: 29440214]
  13. BMC Med Res Methodol. 2013 Sep 18;13:117 [PMID: 24047204]
  14. Cochrane Database Syst Rev. 2017 Aug 10;8:CD008587 [PMID: 28796882]
  15. J Med Screen. 2020 Dec;27(4):223-226 [PMID: 31771406]
  16. BMJ. 2019 Feb 6;364:l240 [PMID: 30728133]

Grants

  1. 17219/Cancer Research UK

MeSH Term

Alphapapillomavirus
Early Detection of Cancer
England
Female
Humans
Mass Screening
Papillomaviridae
Papillomavirus Infections
Qualitative Research
State Medicine
Uterine Cervical Neoplasms

Word Cloud

Created with Highcharts 10.0.0screeningintervalHPVprimary5yearscancerchangeEnglandcan3exploredproposedcurrent3-yearparticipantssafetyintervalscellchangestestcervicalhealthOBJECTIVES:introductionHumanPapillomavirustestingNationalHealthServiceNHSCervicalScreeningProgrammemeans25-49 yearsextendedwomen'sresponsesextensionMETHODS:conductedsemi-structuredphone/videointerviews22 womenaged25-49Participantsselectedvaryagesocioeconomicshistoryattitudesacceptability5-yearInterviewstranscribedverbatimanalysedusingframeworkanalysisRESULTS:AttitudesvariedwantedfrequentbelievingdevelopsquicklyworriedotherstrustedevidencebasedFrequentquestionsconcernedrationalelongerspeeddevelopmentpossibilitymissedoccurringscreensManyfeltreassuredexplainedalongsidemovepreviouslyunawareCONCLUSIONS:CommunicationdonecontextbroaderinformationemphasisingpeoplenegativelowerrisksafelyscreenedeverylongtimeneededdevelopprovidesreassuranceimportanttransparentperfectAcceptabilityextendingHPV-basedyears:interviewstudywomenepidemiologygynaecologypolicypublic

Similar Articles

Cited By (12)