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Testing positive for Human Papillomavirus (HPV) at primary HPV cervical screening: A qualitative exploration of women's information needs and preferences for communication of results

Research output: Contribution to journalArticlepeer-review

Sophie Mulcahy Symmons, Jo Waller, Emily McBride

Original languageEnglish
Article number101529
JournalPreventive Medicine Reports
PublishedDec 2021

Bibliographical note

Funding Information: This study was funded by the National Institute for Health Research (NIHR) as part of a fellowship awarded to Emily McBride (DRF-2017-10-105); the views expressed in this paper are not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Jo Waller was funded by Cancer Research UK ( C7492/A17219 ). Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Human Papillomavirus (HPV) primary cervical screening was implemented across England during 2019, where cervical cell samples are first tested for HPV and cytology is used to triage HPV-positive results. Around 8.5% of women who attend test HPV-positive with normal cytology (HPV+/normal). We aimed to explore women's information needs and suggestions for improvements to result communication following an HPV+/normal result, among those with higher and lower levels of education. In‐depth interviews were conducted with 30 women aged 24–63 who had tested HPV+/normal at routine screening. Secondary qualitative data, not previously reported, were analysed using Framework Analysis to compare themes between those with education lower-than-degree-level vs. degree-level-or-higher (n = 15 in each group). Regardless of education level, women had unanswered questions about their result meaning and the HPV primary screening protocol. Expectations of cervical screening did not always match the service provided, especially regarding content of letters and mode of result delivery. Women with lower education were less clear about the meaning of normal cytology and its link to HPV; and had difficulty sourcing information after their result. Pragmatic suggestions were made for preferences in content, wording, format, and delivery of information in patient communications. Overall, our findings point to areas which can be used by policymakers and healthcare professionals to inform content and communication of results, as HPV primary screening continues to be implemented and refined worldwide. Future research should use these suggestions to develop patient materials and then test them to assess content engagement and information recall.

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