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

Martin Nemec, Jo Waller, Jessica Barnes, Laura Marlow*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


OBJECTIVES: The 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.

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.

Original languageEnglish
Article numbere058635
Pages (from-to)e058635
Number of pages19
JournalBMJ Open
Issue number5
Publication statusPublished - 4 May 2022


  • Alphapapillomavirus
  • Early Detection of Cancer
  • England
  • Female
  • Humans
  • Male
  • Mass Screening
  • Papillomaviridae
  • Papillomavirus Infections/diagnosis
  • Qualitative Research
  • State Medicine
  • Uterine Cervical Neoplasms/prevention & control


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