Women's experiences of repeated HPV testing in the context of cervical cancer screening: a qualitative study.
OBJECTIVE
To evaluate the psychosocial impact of taking part in repeated testing for human papillomavirus (HPV) in the context of cervical cancer screening.


METHODS
In-depth interviews were carried out with 30 women who were HPV positive with normal cytology at trial baseline, and attended for a repeat HPV test 12 months later. Interview transcripts were analysed qualitatively using Framework Analysis to identify emergent themes.


RESULTS
Although women often experienced serious negative emotional consequences at the time of their first positive result, these did not generally last during the year between tests once questions about HPV had been resolved. The emotional impact of testing positive a second time was greater for many women, sometimes causing them to overcome their embarrassment about having a sexually transmitted infection in order to disclose their result and seek support. Among the women interviewed there was an overwhelming preference for immediate colposcopy rather than continued surveillance for persistent HPV. This was associated with the desire for a speedy resolution, and fears about progression to cancer.


CONCLUSIONS
Although most women did not appear to suffer on-going anxiety while waiting for a second HPV test, this seemed contingent on their information needs being met. Women appeared to be more distressed by a second HPV positive result than a single one, and expressed a clear preference for immediate colposcopy over continued surveillance. This finding might have implications for the way in which HPV testing could be used in cervical cancer screening programmes.
Waller
Jo
J
Cancer Research UK, Health Behaviour Unit, Department of Epidemiology and Public Health, UCL, 2-16 Torrington Place, London WC1E 6BT, UK. j.waller@ucl.ac.uk
McCaffery
Kirsten
K
Kitchener
Henry
H
Nazroo
James
J
Wardle
Jane
J
D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003127:Colposcopy / Q000379:methods / Q000592:standards*; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications* / Q000175:diagnosis; D010507:Periodicity; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000523:psychology / Q000821:virology