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(…)’

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)’

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.’

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.’

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.’