Understanding women's hesitancy to undergo less frequent cervical cancer screening

Gerend, Mary A.; Shepherd, Melissa A.; Kaltz, Emily A.; Davis, Whitney J.; Shepherd, Janet E.

doi:10.1016/j.ypmed.2016.11.028

Cited by 29 publications

(58 citation statements)

References 36 publications

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“…Many providers also followed an annual or 2-year screening interval for primary HPV testing, despite recommendations for a 3-year interval (Huh et al, 2015; American College of Obstetricians and Gynecologists, 2016) and evidence in other countries which supports the effectiveness of even longer intervals, up to 10 years (Peto and Gilham, 2017; Elfström et al, 2014; Dillner et al, 2008; Gage et al, 2014; Isidean et al, 2016). This preference for more frequent screening may reflect a lack of familiarity with screening recommendations (Isidean et al, 2016), concerns about maintaining visit volume (Henderson et al, 2014) or patient preference (Teoh et al, 2015; Gerend et al, 2017). Primary HPV testing of women younger than recommended and screening more frequently than recommended will likely result in increased colposcopy referrals (Boardman and Robison, 2013) and adverse birth outcomes (Bjørge et al, 2016), with no accompanying rise in the detection of high-grade cervical disease.…”

Section: Discussionmentioning

confidence: 99%

Primary HPV testing recommendations of US providers, 2015

Cooper¹,

Saraiya

2017

Preventive Medicine

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Objective To investigate the HPV testing recommendations of US physicians who perform cervical cancer screening. Methods Data from the 2015 DocStyles survey of U.S. health care providers were analyzed using multivariate logistic regression to identify provider characteristics associated with routine recommendation of primary HPV testing for average-risk, asymptomatic women ≥30 years old. The analysis was limited to primary care physicians and obstetrician-gynecologists who performed cervical cancer screening (N = 843). Results Primary HPV testing for average-risk, asymptomatic women ≥30 years old was recommended by 40.8% of physicians who performed cervical cancer screening, and 90.1% of these providers recommended primary HPV testing for women of all ages. The screening intervals most commonly recommended for primary HPV testing with average-risk, asymptomatic women ≥30 years old were every 3 years (35.5%) and annually (30.2%). Physicians who reported that patient HPV vaccination status influenced their cervical cancer screening practices were almost four times more likely to recommend primary HPV testing for average-risk, asymptomatic women ≥30 years old than other providers (Adj OR = 3.96, 95% CI = 2.82–5.57). Conclusion Many US physicians recommended primary HPV testing for women of all ages, contrary to guidelines which limit this screening approach to women ≥25 years old. The association between provider recommendation of primary HPV testing and patient HPV vaccination status may be due to anticipated reductions in the most oncogenic HPV types among vaccinated women.

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Section: Discussionmentioning

confidence: 99%

Primary HPV testing recommendations of US providers, 2015

Cooper¹,

Saraiya

2017

Preventive Medicine

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“…The study selection flow diagram is presented in Figure 2. We retained 22 primary studies: 5 of qualitative methodology [29][30][31][32][33], 15 of quantitative methodology [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 2 in which both methodologies were used [49,50]. Seventeen studies originate in high income countries (8-USA, 2-Canada, 5-Europe and 2 in Australia) and five in low and middle income countries (1-Mexico, 1-El Salvador, 1-China, 1-India and 1 in Nigeria).…”

Section: Summary Of Included Studies and Study Qualitymentioning

confidence: 99%

“…Quality appraisal revealed low risk of bias in 18 studies and high risk of bias in 4 studies [40,42,45,49]. Among low risk of bias studies, only six were guided by an explicit theoretical framework [29-31, 40, 44, 50] or provided evidence of pilot testing of the data collection tool [29,32,[37][38][39]41].…”

Section: Summary Of Included Studies and Study Qualitymentioning

confidence: 99%

“…Among low risk of bias studies, only six were guided by an explicit theoretical framework [29-31, 40, 44, 50] or provided evidence of pilot testing of the data collection tool [29,32,[37][38][39]41]. In high risk of bias studies, theoretical frameworks were not used, the validity and reliability of the measurement tools was not assessed, no sample size calculations were provided [40,42,49] and few details were provided related to the recruitment…”

Section: Summary Of Included Studies and Study Qualitymentioning

confidence: 99%

“…Subjective norms comprise healthcare provider (HCP) recommendation [29,36,38,39,44,46,49,50], screening guidelines [29,40,44,50], and the opinions of spouse and friends [29,40,42,44,50].…”

Section: Attitudes Beliefs and Subjective Normsmentioning

confidence: 99%

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Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis

Tatar

Thompson

Naz

et al. 2018

Preventive Medicine

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Primary screening for cervical cancer is transitioning from the longstanding Pap smear towards implementation of an HPV-DNA test, which is more sensitive than Pap cytology in detecting high-risk lesions and offers greater protection against invasive cervical carcinomas. Based on these results, many countries are recommending and implementing HPV testing-based screening programs. Understanding what factors (e.g., knowledge, attitudes) will impact on HPV test acceptability by women is crucial for ensuring adequate public health practices to optimize cervical screening uptake. We used mixed methods research synthesis to provide a categorization of the relevant factors related to HPV primary screening for cervical cancer and describe their influence on women's acceptability of HPV testing. We searched Medline, Embase, PsycINFO, CINAHL, Global Health and Web of Science for journal articles between January 1, 1980 and October 31, 2017 and retained 22 empirical articles. Our results show that while most factors associated with HPV test acceptability are included in the Health Belief Model and/or Theory of Planned Behavior (e.g., attitudes, knowledge), other important factors are not encompassed by these theoretical frameworks (e.g., health behaviors, negative emotional reactions related to HPV testing). The direction of influence of psychosocial factors on HPV test acceptability was synthesized based on 14 quantitative studies as: facilitators (e.g., high perceived HPV test benefits), barriers (e.g., negative attitudes towards increased screening intervals), contradictory evidence (e.g., sexual history) and no impact (e.g., high perceived severity of HPV infection). Further population-based studies are needed to confirm the impact of these factors on HPV-based screening acceptability.

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Women's attitudes and understanding of cervical cancer and the new National Cervical Screening Program

Nagendiram

Bidgood

Banks

et al. 2020

Health Prom J of Aust

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Australia may be the first country to eliminate cervical cancer as a public health issue due to its longstanding National Cervical Screening Program (NCSP) and the early introduction of the Gardasil vaccine for Human Papillomavirus (HPV) into the National Immunisation Program Schedule. 1 In December 2017, Australia updated the NCSP by replacing bi-annual pap smears with a 5-yearly Cervical Screening Test (CST) for Human Papillomavirus (HPV). 2,3 Women now commence cervical screening at 25 years old. This delay in screening is to prevent the overscreening and overinvestigation of young women as cervical screening has not reduced the incidence or mortality rate from cervical cancer in women under 25 since the introduction of the NCSP in Australia. Furthermore, the new NCSP incorporates the opportunity for self-sampling among eligible women. Women over 30, who are under-and never screened, can be offered a self-collected high vaginal swab instead of a traditional pap smear. 2 As the new NCSP was implemented 2 years ago, there is minimal research regarding Australian women's awareness and attitudes towards the new guidelines. A recent survey by the Australian Cervical Cancer Foundation (ACCF) identified that only 23% of women were aware that the CST should be performed every 5 years. 4 A study of

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Understanding women's hesitancy to undergo less frequent cervical cancer screening

Cited by 29 publications

References 36 publications

Primary HPV testing recommendations of US providers, 2015

Primary HPV testing recommendations of US providers, 2015

Factors associated with human papillomavirus (HPV) test acceptability in primary screening for cervical cancer: A mixed methods research synthesis

Women's attitudes and understanding of cervical cancer and the new National Cervical Screening Program

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