Table 3

Results of the qualitative studies that assessed attitudes towards HPV-based screening

ReferencePhenomena of interestPositive attitude
(reported frequencies)
Negative attitude
(reported frequencies)
Neutral attitude
(reported frequencies)
Reasons/answers provided by women
Dodd, 202029 Understanding the screening purpose
  • Experiencing less anxiety, stress and discomfort due to screening less often (NR)

  • Positive views justified with the new technology being more sensitive and more accurate (NR)

  • Concern that cancer might be missed in between screens because of the extended screening interval (NR)

  • Believed the new HPV-based screening programme could help increase uptake of the HPV vaccination (some women)

  • Changes would have minimal impact on their screening behaviour (most women)

  • ‘Well the fact that if it’s done every 5 years as opposed to 2 then obviously having to go for less testing, means less anxiety and less stress so on that basis that’s good(…)’

McCaffery, 200326 Understanding the implication of a positive finding; understanding the screening purpose
  • Some would benefit from early detection and psychological benefits of being reassured following testing overtakes negative aspects (some women)

  • Many would feel anger, distress, anxiety, if tested positive for HPV (many)

  • Many fear that being tested might communicate mistrust and infidelity (many)

  • Many think that clear and accurate information is critical as the response to HPV-based screening (many)

  • ‘My family would see no point to it as you only have one partner’

  • ‘Being single, my family will be suspicious (if I go for HPV testing)’

McCaffery, 200627 Understanding the implication of a positive finding; understanding the screening purpose
  • Would cause few problems, if tested positive for HPV (some women in relationships)

  • Feel reassured by additional testing (some women)

  • The majority would feel distress, anxiety and be upset, if tested positive for HPV (general response)

  • Women would feel anxiety about disclosing their HPV positivity to partner, family or friends (NR)

  • Understanding that HPV is an extremely common infection appeared to reduce the stigma (some women)

  • ‘A normal thing for many women to have.’

  • ‘I had this association in my head, an old Catholic thing that (…) promiscuity and cell changes would go together.’

Nagendiram, 202030 Understanding the screening purpose
  • HPV can be detected before abnormal cells become detectable by a Pap smear (some women)

  • Reduced screening would make life easier, as the screening procedure was described as ‘uncomfortable’ (some women)

  • Fear of missing cancer because of increased screening intervals, as clinicians may not always get a ‘clear swab’ (NR)

  • Fear of missing cancer caused by ‘things other than HPV’ (NR)

  • Concerned because of personal experiences (NR)

  • Faith in the doctors (several women)

  • Participants were more receptive towards the new guidelines after being provided with some information—for example, about the slow progression of cervical cancer (participants)

  • ‘Well I like the idea of not having to go back every 2 years and not be in that uncomfortable position.’

  • ‘A friend of mine got cervical cancer when she was 21… If they didn’t catch it early, she’d be dead.’

Patel, 201828 Understanding the personal risk; understanding the implication of a positive finding; understanding the screening purpose
  • Would handle it in very pragmatic terms, if tested positive for HPV (many woman who had not received a positive HPV result)

  • Would feel emotions of shock, fear, embarrassment, when tested positive for HPV (the majority of women)

  • Some do not perceive themselves at risk for having a sexually transmitted infection, therefore don’t feel the need to be tested for HPV (some women in relationships)

  • Some would be willing to accept HPV-based screening as a test for cancer (some women)

  • Some thought that normalising HPV-based screening and providing more information would reduce the stigma attached to it (some women)

  • ‘Yeah, I think some people would not feel comfortable being tested for a sexually transmitted disease, you know having a smear test is not linked with that as far as people are aware, all they’re going for is a routine smear test.’

  • HPV, human papillomavirus; NR, not reported.