Understanding anxiety and attendance in cervical screening
Research type
Research Study
Full title
HPV primary testing in cervical cancer screening: using behavioural science to understand anxiety and attendance
IRAS ID
236982
Contact name
Jo Waller
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2018/06/102, Data protection number
Duration of Study in the UK
2 years, 2 months, 1 days
Research summary
Human papillomavirus (HPV) is a common sexually transmitted infection which causes nearly all cervical cancers. There are around 3,000 new cases of cervical cancer every year in the UK.
The NHS Cervical Screening Programme (NHSCSP) aims to prevent cervical cancer by looking for abnormal cells in the cervix and removing them before they turn into cancer. The NHSCSP will soon test all cervical screening samples for HPV before deciding whether to look for abnormal cell changes. This is called HPV primary testing and it will be rolled out across England from 2019. This means that all women attending cervical screening will learn their HPV test results through letters delivered to their home. The results letters will tell women whether they are HPV positive or HPV negative, as well as whether they have any abnormal cell changes.
It is very important that psychological research helps decide what NHSCSP results letters and information leaflets say. We know that knowledge about HPV and its connection to cervical cancer is poor among women in the UK. We also know that some women can get upset, confused and/or experience stigma after testing positive for HPV, partly because of it being sexually transmitted. Therefore, the wording and information in NHSCSP letters needs to make sense and be clear so that women correctly understand their risk of getting cervical cancer. It is also very important that women are not worried about their results if they do not need to be.In HPV primary testing, one group of women who might especially struggle to understand their screening results is those who test positive for HPV but have no abnormal cell changes. This is because they will find out they have HPV, but they will not get invited to screening again for another 12 months and will not get any treatment. This is because although HPV puts them at higher risk of getting cervical cancer, without any abnormal cell changes it is very unlikely that they will get cervical cancer within 12 months. It is likely that their immune system will get rid of HPV in this time. However, this can be complicated for women to understand and difficult for the NHSCSP to know how to communicate in letters. We think that some women in this group may not understand these test results. It is important that these women are not too worried or upset about their test results, and they come back to cervical screening again in 12 months.
We propose two main projects:1. A cross-sectional study to identify psychological predictors of anxiety and attendance in women testing HPV positive with normal cytology, with a sub-study built in to test whether the application of behavioural science in cover letters influences response rate.
2. An interview study to understand anxiety and beliefs in women testing HPV positive with normal cytology.REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
18/EM/0227
Date of REC Opinion
24 Aug 2018
REC opinion
Further Information Favourable Opinion