Influences on human papillomavirus (HPV)-related information needs among women having HPV tests for follow-up of abnormal cervical cytology

Abstract

ObjectivesTesting for human papillomavirus (HPV) infection has recently been introduced into cervical screening programmes. We investigated (1) barriers to accessing and absorbing information and (2) factors that influence information needs among women undergoing HPV tests.MethodsIn-depth interviews were conducted with 27 women who had HPV tests performed in a colposcopy clinic as part of follow-up of low-grade abnormal cytology or post-treatment for cervical intraepithelial neoplasia (CIN). Interviews were transcribed verbatim, coded and analysed using Framework Analysis, to identify main themes and sub-themes.ResultsAmong these women, barriers to accessing and absorbing HPV information were: being overwhelmed with information; context of the HPV test; colposcopy clinic experience(s); women's perceptions of medical professionals’ behaviours and attitudes, and information available on the Internet. Factors influencing women's HPV information needs were: concerns surrounding abnormal cytology or diagnosis of CIN; amount of information provided about HPV; awareness HPV is sexually transmitted; previous negative health care experience(s); and the HPV test in relation to other life events. The timing of delivery of HPV information was key to women absorbing or remembering the information given; it was important that information was given in stages rather than altogether.ConclusionsIn women undergoing HPV testing during follow-up, the amount and timing of delivery of HPV information requires careful consideration. Significant barriers exist to accessing and absorbing HPV information which, unless addressed, could have serious implications in terms of women's comprehension of HPV tests. Given the expanding use of HPV testing within cervical screening, further research on HPV-related information issues is needed.

Psychological effect of cervical cancer screening when changing primary screening method from cytology to high‐risk human papilloma virus testing

“…Information must necessarily be tailored to match women's needs to be effective . Moreover, knowledge has the potential to reduce negative psychological outcomes . Interestingly, in our study women in the hrHPV arm had significantly more knowledge about their own screening test results than women in the cytology arm.…”

HPV primary cervical screening in England: Women's awareness and attitudes

“…For women who had had an abnormal smear result (with or without HPV) and/or undergone treatment, the fear of developing cancer was worse than the screening test. Anxiety associated with abnormal cytology and/or treatment has been shown to outweigh any concerns regarding HPV status specifically . Primary HPV testing will result in a greater number of women receiving what might be considered an “abnormal” result, ie, a positive HPV result.…”

“…Anxiety associated with abnormal cytology and/or treatment has been shown to outweigh any concerns regarding HPV status specifically. 14 to 24 year olds. 9 Consequently, more women might experience adverse psychological effects, and it is unknown if women, who are cytology negative but HPV positive, will be content to wait 12 months without any treatment, as is proposed in the primary HPV screening protocol.…”

“…Having an hrHPV diagnosis has been found to result in increased anxiety and distress levels . It is unclear whether the associated negative emotions are long lasting, and Irish studies have suggested that it is an abnormal result rather than the HPV test itself which results in heightened anxiety levels . Australian and Canadian studies have shown that a high percentage of women (78% and 84%, respectively) are willing to accept the change to primary HPV testing from cytology, but both studies found that acceptance rates reduced significantly with the proposed extended screen intervals.…”

Cervical cancer prevention and screening: the role of human papillomavirus testing

“…In a 2015 study, women described barriers to absorbing HPV‐related data; for instance, being overwhelmed with information and having difficulty in understanding the context of the HPV test . The study emphasised the importance of giving information in stages.…”