Getting the timing right: Women’s views on the best time to announce changes to cancer screening policy recommendations

Dodd, Rachael H; Nickel, Brooke; Smith, Megan A.; Brotherton, Julia; McCaffery, Kirsten

doi:10.1016/j.pmedr.2020.101268

Cited by 8 publications

(9 citation statements)

References 13 publications

(15 reference statements)

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“…De-valuing of women's health and beliefs that the change was a cost-cutting exercise, were also expressed, in line with the Australian petition. (6) The views expressed following the provision of information were strikingly similar to another Australian study (11) which found that despite initially low awareness of HPV primary screening and understanding of HPV, concerns about longer intervals could be alleviated for many women by presenting information explaining the rationale for the changes, including the introduction of HPV primary screening, HPV-to-cancer development and the length of time this takes. These findings are also consistent with a quantitative study that showed women who were presented with this information had a better understanding of the change.…”

Section: Discussionsupporting

confidence: 54%

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

Němec¹,

Waller²,

Barnes³

et al. 2022

Preprint

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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.

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Section: Discussionsupporting

confidence: 54%

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

Němec¹,

Waller²,

Barnes³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“… 10 More recently, a qualitative study suggested that Australian women wanted to be consulted about any further changes to the cervical screening programme prior to implementation. 11 Previous UK-based research suggests acceptability of extended screening intervals may be influenced by how the change is presented. A clearer presentation of the rationale for extended intervals could increase acceptability.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

View full text Add to dashboard Cite

ObjectivesThe 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.MethodsWe 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.ResultsAttitudes 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.ConclusionsCommunication 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.

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“…Greater personalisation of information about the interval change, or discussion with a health care professional may be needed to provide reassurance for women who have previously experienced abnormal cells changes. Training to ensure health care professionals are confident in explaining the rationale for extended intervals is important (R H. Dodd et al, 2020).…”

Section: Practical Implicationsmentioning

confidence: 99%

“…Previous work suggests that transitions to longer screening intervals are not always considered acceptable to screening participants and can result in worry and concern (Obermair et al, 2018; Ogilvie et al, 2016; Silver et al, 2015). However, acceptability of extended screening intervals can be improved by explaining the rationale for changes (Hill et al, 2021) and by involving women in the development of communication strategies designed to explain program changes (Rachael H Dodd et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Testing key messages about extending cervical screening intervals

Marlow

Němec

Waller

et al. 2022

Preprint

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Objectives: We tested the impact of different messages about the rationale for extended screening intervals on acceptability of an extension. Methods: Women in England aged 25-49 years (n=2931) were randomised to read different messages about extending intervals from 3 to 5 years. Outcome measures were general acceptability and six components from the Theoretical Framework of Acceptability (TFA). Results: The control group were less likely to find the change acceptable (43%) than the groups who saw additional messages (47-63%). Women who saw messages about interval safety, test accuracy or the speed of cell changes had more positive affective attitudes, higher ethicality beliefs, a better understanding of the reasons for the interval change and were more likely to believe that 5-year intervals would be safe. Being up-to-date with screening and previous abnormal results were associated with finding 5-yearly screening unacceptable. Conclusions: Emphasising the slow development of cell changes following an HPV negative result and the safety of longer intervals, alongside messages about the accuracy of HPV primary screening is important. Practical implications: Campaigns explaining the rationale for increased screening intervals are likely to improve acceptability. Though some women who feel at increased risk, may remain worried even when the rationale is explained.

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Getting the timing right: Women’s views on the best time to announce changes to cancer screening policy recommendations

Cited by 8 publications

References 13 publications

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

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

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

Testing key messages about extending cervical screening intervals

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