"If you can't treat HPV, why test for it?" Women's attitudes to the changing face of cervical cancer prevention: A focus group study

Abstract

Open Access Research article “If you can’t treat HPV, why test for it?” Women’s attitudes to the changing face of cervical cancer prevention: a focus group study

Judith McRae1*, Cara Martin2, John O’Leary3, Linda Sharp1 and On behalf of the Irish Cervical Screening Research Consortium (CERVIVA)

* Corresponding author: Judith McRae judemcrae@yahoo.com

Author Affiliations

1 National Cancer Registry, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland

2 Trinity College Dublin, Dublin, Ireland

3 Coombe Women and Infants University Hospital, Dolphin’s Barn, Dublin 8, Ireland

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BMC Women's Health 2014, 14:64 doi:10.1186/1472-6874-14-64

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6874/14/64

Received: 30 November 2013 Accepted: 25 April 2014 Published: 6 May 2014

© 2014 McRae et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Abstract Background

The relationship between infection with high-risk strains of human papillomavirus (HPV) and cervical cancer is transforming prevention through HPV vaccination and HPV oncogenic testing. In Ireland, a national cervical cancer screening programme and HPV vaccination were recently launched; HPV testing is currently being integrated into the screening programme. Women’s views on the transformation of cervical cancer prevention have been relatively little investigated. Methods

Using qualitative focus groups, we determined women’s knowledge, attitudes towards, and acceptability of cervical cancer screening, HPV oncogenic testing and vaccination of HPV. Fifty nine women, recruited through primary care in Ireland, participated in ten focus groups. A dynamic topic guide was developed from literature reviewed. Women were provided with standardised information about HPV infection, HPV testing. Discussion transcripts were analysed thematically. Results

The primary themes that emerged regarding HPV infection were: knowledge, emotional response and societal influences; especially those of healthcare practitioners. Knowledge, logistics, and psychological impact were the primary themes relating to HPV testing. Women’s attitudes towards HPV testing changed during discussion as issues were explored, thus demonstrating the complexity of this issue; lack of existing treatment for HPV infection influenced women’s attitudes, attachment to existing cervical cancer screening also was a significant factor. Conclusions

Women currently have a strong attachment to cytology and any changes towards HPV primary testing will need to be managed carefully. To ensure that future cervical cancer prevention strategies will be acceptable to women, sufficient thought will have to be given to information provision and education. We identified the importance to women of healthcare practitioners’ opinions regarding HPV. Appropriate and timely information on HPV will be crucial in order to minimise possible psychological effects women may have.