Maximising the acceptability of extended time intervals between screens in the NHS Cervical Screening Programme: An online experimental study

Abstract

Objective: The NHS Cervical Screening Programme plans to increase the screening interval for women aged 25-49 years who test negative for human papillomavirus (HPV) from 3 to 5 years. This exploratory cross-sectional online survey tested the impact of different information about the proposed change on acceptability of a longer interval.

Methods: Women aged 18-45 (n=585) were individually randomised to one of three information exposure groups differing in the level of information provided about the screening interval change: 1) Basic information; 2) Basic information with additional detail about timeline of HPV infection; 3) as (2) but with the addition of a diagram. Acceptability of the change (favourable and unfavourable attitudes) was assessed post-exposure alongside HPV timeline beliefs. We used ANOVA and regression analyses to test for between-group differences.

Results: Women in Group 3 (Extended plus diagram) had higher scores on the favourable attitudes sub-scale compared with Group 1 (Basic) and more accurate HPV timeline beliefs compared with both Group 1 (Basic) and 2 (Extended). There were no between-group differences in unfavourable attitudes. After adjusting for demographic factors, higher favourable attitudes score was independently predicted by being in Group 3 compared to Group 1, more accurate HPV timeline beliefs and previous irregular or non-attendance at screening.

Conclusions: Overall, acceptability of an increased screening interval was moderate but providing women with information about the safety and rationale for this change may improve acceptability. In particular, communicating the long timeline from HPV exposure to cervical cancer may reassure women about the safety of the proposed changes.