title: Women's intentions to receive cervical cancer screening with primary human papillomavirus testing.
abstract: We explored the potential impact of human papillomavirus (HPV) testing on women's intentions to be screened for cervical cancer in a cohort of Canadian women. Participants aged 25-65 years from an ongoing trial were sent a questionnaire to assess women's intentions to be screened for cervical cancer with HPV testing instead of Pap smears and to be screened every 4 years or after 25 years of age. We created scales for attitudes about HPV testing, perceived behavioral control, and direct and indirect subjective norms. Demographic data and scales that were significantly different (p < 0.1) between women who intended to be screened with HPV and those who did not intend were included in a stepwise logistic regression model. Of the 2,016 invitations emailed, 1,538 were received, and 981 completed surveys for a response rate of 63% (981/1,538). Eighty-four percent of women (826/981) responded that they intended to attend for HPV-based cervical cancer screening, which decreased to 54.2% when the screening interval was extended, and decreased further to 51.4% when screening start was delayed to age of 25. Predictors of intentions to undergo screening were attitudes (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.15, 1.30), indirect subjective norms (OR: 1.02; 95% CI: 1.01, 1.03) and perceived behavioral control (OR: 1.16; 95% CI: 1.10; 1.22). Intentions to be screened for cervical cancer with HPV testing decreased substantially when the screening interval was extended and screening started at age of 25. Use of primary HPV testing may optimize the screening paradigm, but programs should ensure robust planning and education to mitigate any negative impact on screening attendance rates.
authors.affiliation: Department of Family Practice and Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre for Disease Control, Vancouver, BC, Canada.
authors.forename: Gina S
authors.initials: GS
authors.lastname: Ogilvie
authors.forename: Laurie W
authors.initials: LW
authors.lastname: Smith
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Niekerk
authors.forename: Fareeza
authors.initials: F
authors.lastname: Khurshed
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Vivek
authors.initials: V
authors.lastname: Goel
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Rimer
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Greene
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hobbs
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Coldman
authors.forename: Eduardo L
authors.initials: EL
authors.lastname: Franco
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: HPV; cervical cancer screening; intention; theory of planned behavior