What is it about?
Almost all cervical cancer is caused by high-risk human papilloma virus (HPV), and the development of HPV vaccination and HPV-testing have made cervical cancer almost completely preventable. Scientific evidence supports reducing cervical screening frequency from every 3 years to every 5 years for women and persons with a cervix who test negative for high-risk HPV. Recently, Scotland and Wales have made the change to 5-yearly screening intervals, and other countries who have adopted HPV primary screening are likely to follow suit. In this study we were interested in women’s perception of proposed changes to reduced cervical screening frequency, particularly how perceptions of the HPV vaccine influence perception and decision-making around cervical screening. Through interviews with 44 women, we found that most were opposed to any reduction in cervical screening frequency. The reasons for this included concerns of HPV going undetected and developing into cervical cancer, disempowerment, and increased anxiety. Importantly, women believed that cervical screening is a test for cancer and that HPV vaccination does not provide reliable or adequate protection against cervical cancer. The felt they were ill-informed about the reasons for the proposed change, and that having access to the evidence for the safe reduction in screening frequency may be persuasive in accepting reduced screening frequency.
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Why is it important?
It is possible that lower acceptability of reduced screening frequency may have unintended consequences on cervical screening outcomes, for example reduced screening intentions and behaviour. To increase public support for reduced cervical screening frequency and minimise the potential for negative consequences on cervical screening participation and health outcomes, our findings suggest that it is imperative to develop public health initiatives and education campaigns explaining why changes to the screening programme are required before any such changes take place.
Perspectives
This study is important and timely, as countries prepare to make changes to the gap between routine cervical screens. The scientific evidence demonstrates the safety of a longer screening interval, but our findings show that women are reluctant to accept a longer screening interval. Our study findings suggest that women's own perception that they lack sufficient knowledge of the reasons for changes in screening frequency is true. To combat this, the rationale for extending screening intervals should to be communicated with screening recipients ahead of any policy changes. Clear and specific information is required, which emphasizes that cervical screening is not a test for cancer but a test for the virus which causes cervical cancer, and the long interval from HPV infection to cervical cancer, and how HPV vaccination relates to cervical cancer and screening.
Dr Susanna Kola-Palmer
Department of Psychology, University of Huddersfield
Read the Original
This page is a summary of: Attitudes to reducing cervical screening frequency among UK women: A qualitative analysis, Psycho-Oncology, March 2023, Wiley,
DOI: 10.1002/pon.6117.
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