How does information on the harms and benefits of cervical cancer screening alter the intention to be screened?: a randomized survey of Norwegian women

Abstract

Cervical cancer (CC) is the 13th most frequent cancer among women in Norway, but the third most common among women aged 25-49 years. The national screening program sends information letters to promote screening participation. We aimed to evaluate how women's stated intention to participate in screening and pursue treatment changed with the provision of additional information on harms associated with screening, and to assess women's preferences on the timing and source of such information. We administered a web-based questionnaire to a panel of Norwegian women aged 25-69 years and randomized into three groups on the basis of when in the screening process additional information was introduced: (i) invited for routine screening, (ii) recommended an additional test following detection of cellular abnormalities, and (iii) recommended precancer treatment. A fourth (control) group did not receive any additional information. Results show that among 1060 respondents, additional information did not significantly alter women's stated intentions to screen. However, it created decision uncertainty on when treatment was recommended (8.76-9.09 vs. 9.40; 10-point Likert scale; P=0.004). Over 80% of women favored receiving information on harms and 59% preferred that information come from a qualified public health authority. Nearly 90% of women in all groups overestimated women's lifetime risk of CC. In conclusion, additional information on harms did not alter Norwegian women's stated intention to screen for CC; yet, it resulted in greater decision uncertainty to undergo precancer treatment. Incorporating information on harms into invitation letters is warranted as it would increase women's ability to make informed choices.

Reasons for No Colonoscopy After an Unfavorable Screening Result in Dutch Colorectal Cancer Screening: A Nationwide Questionnaire

“…41 However, more information might not be sufficient to improve knowledge because studies report that individuals unwilling to undergo CRC screening tend to avoid evidence-based information on screening, 42 and perceptions and beliefs of participants are already formed before they receive the invitation and information about screening. 43 In addition, providing additional information on cancer screening programs might not influence the decision to screen yet could increase decisional uncertainty, 44 and difficulties in understanding risks combined with preconceptions about screening could lead to a gap in perception between the information provided and participants' understanding of the information. 45 Targeting these misconceptions might therefore need a well-thought-out approach that is specifically tailored to participants' perceptions.…”

Knowledge towards Cervical Cancer Screening and Associated Factors among Urban Health Extension Workers at Addis Ababa, Ethiopia

“…The tool contains 14 items (5 dichotomous and 9 multiple responses), which cover the knowledge of participants regarding vulnerable groups, predisposing factors, risk factors, signs and symptoms and screening methods, treatment modality, and benefits of cervical cancer screening. Participants were asked to choose one of the two options: Yes (1) or No (1) for dichotomous questions and for multiple response questions we converting each item to Yes (1) or No (0). The scores ranged from 0 to 31.…”

“…Cervical cancer is preventable and remains a leading cause of avoidable death among women worldwide. Approximately 90% of women in their lifetime encounter the risk of cervical cancer (CC) in all age groups [1]. The burden of cervical cancer becomes worth, globally, in the factual data it accounts for more than 5 hundred thousand new cases each year, and about 80% of the cases arise in low-income countries [2].…”