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

Objectives: The introduction of primary HPV testing in the NHS Cervical Screening Programme in England means the screening interval for 25-49-year-olds can be extended from 3 to 5 years. We explored womens 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.

Download Full-text

Screening history and FIGO-stages among Danish women with cervical cancer in 2012–2014: a register-based study

Scientific Reports ◽

10.1038/s41598-019-56833-w ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Abir Khalil Bchtawi ◽

Sinem Saritas ◽

Doris Schledermann ◽

René dePont Christensen ◽

Kirsten Marie Jochumsen

Keyword(s):

Cervical Cancer ◽

Screening Programme ◽

Treatment Options ◽

Cervical Screening ◽

Participation Rate ◽

Figo Stage ◽

Risk Of Death ◽

Study Population ◽

Node Metastases ◽

Screening History

AbstractThe objective was to examine whether attendance in the mass cervical screening programme has implications for the prognosis when cervical cancer is diagnosed. We performed a retrospective analysis of all cases of cervical cancer between 1st of January 2012 and 31st of December 2014 in the Region of Southern Denmark. The cases were retrieved from the Danish National Pathology Registry, PatoBank. Odds ratios (OR) with confidence intervals (95% CI) were calculated for attendees versus non-attendees of the screening programme by using χ2-test. 216 patients were included in the study. 61.6% of the study population had not attended the screening programme. Patients who had attended the programme were characterised by disease in low stage (OR = 3.14, 95% CI; 1.66 to 5.92), treatment with surgery alone (OR = 2.63, 95% CI; 1.49 to 4.64) and a lower risk of death (OR = 0.36, 95% CI; 0.15 to 0.87). Adenocarcinomas were more often detected among attendees of the programme compared to squamous cell carcinomas (OR = 4.06, 95% CI; 2.03 to 8.14). Statistically significant results regarding relapse of cancer (OR = 0.62, 95% CI; 0.23 to 1.68, p = 0.47) and lymph node metastases (OR = 0.62, 95% CI; 0.32 to 1.21, p = 0.19) were not found. Cervical cancer detected in women who had attended the mass cervical screening programme prior to the diagnosis, was shown to have a statistically significant lower FIGO stage (p = 0.0004) and was therefore linked to less extensive treatment options. Continued focus on increasing the participation rate of the programme is of importance, as the nonattendance rate continues to be high.

Download Full-text

Psychological Impact of Primary Screening (PIPS) for HPV: a protocol for a cross-sectional evaluation within the NHS cervical screening programme

BMJ Open ◽

10.1136/bmjopen-2016-014356 ◽

2016 ◽

Vol 6 (12) ◽

pp. e014356 ◽

Cited By ~ 9

Author(s):

Emily McBride ◽

Laura Marlow ◽

Alice S Forster ◽

Sue Moss ◽

Jonathan Myles ◽

...

Keyword(s):

Screening Programme ◽

Cervical Screening ◽

Psychological Impact ◽

Cross Sectional ◽

Primary Screening

Download Full-text

‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia

BMJ Open ◽

10.1136/bmjopen-2017-019171 ◽

2018 ◽

Vol 8 (2) ◽

pp. e019171 ◽

Cited By ~ 25

Author(s):

Helena M Obermair ◽

Rachael H Dodd ◽

Carissa Bonner ◽

Jesse Jansen ◽

Kirsten McCaffery

Keyword(s):

Cervical Cancer ◽

Content Analysis ◽

Women’S Health ◽

Women's Health ◽

Screening Programme ◽

Cervical Screening ◽

Pap Smears ◽

Hpv Testing ◽

Incidence And Mortality ◽

Screening Intervals

ObjectivesThe incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18–69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25–74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, ‘Stop May 1st Changes to Pap Smears—Save Women’s Lives’, opposing the changes, which received over 70 000 signatures and almost 20 000 comments.MethodsContent analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February–March 2017.ResultsNineteen codes were identified, reflecting four themes: (1) valuing women’s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women’s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted.ConclusionsScreening changes within this selected group were perceived as threatening women’s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes.

Download Full-text

Understanding HPV and cervical screening

Practice Nursing ◽

10.12968/pnur.2022.33.1.14 ◽

2022 ◽

Vol 33 (1) ◽

pp. 14-17

Author(s):

Sarah Butler ◽

Yvonne Wilkinson

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Screening Programme ◽

Cervical Screening ◽

Cervical Cancers ◽

Primary Screening ◽

Primary Test ◽

Hpv Screening ◽

Cervical Cells

Cervical cancer is preventable and curable. Sarah Butler and Yvonne Wilkinson explain how the cervical screening programme has changed from a cytology based test to HPV primary screening Screening for human papillomavirus is now the primary test for cervical screening in England, Wales and Scotland. Cervical screening for those individuals with a cervix routinely occurs every 3 years for those aged 25–49 (24½ in England) and every 5 years for those aged 50–64. Over 99.7% of cervical cancers are caused by human papillomavirus. Cervical cancer is preventable and curable; primary HPV screening can detect early changes in cervical cells allowing for effective monitoring and treatment.

Download Full-text