Social and psychological impact of HPV testing in cervical screening: a qualitative study
- 1Screening and Test Evaluation Program, School of Public Health, Edward Ford Building (A27), University of Sydney, NSW 2006, Australia
- 2Cancer Research UK, Health Behaviour Unit, Department of Epidemiology and Public Health, UCL, 2-16 Torrington Place, London WC1E 6BT, UK
- 3Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, UK
- Correspondence to: Kirsten McCaffery Screening and Test Evaluation Program, School of Public Health, Edward Ford Building (A27), University of Sydney, NSW 2006, Australia;
- Accepted 26 July 2005
Objective: Human papillomavirus (HPV) testing has been proposed for inclusion in the UK cervical screening programme. While testing may bring some benefits to the screening programme, testing positive for HPV, a sexually transmitted virus, may have adverse social and psychological consequences for women. The aim of this study was to examine the social and psychological impact of HPV testing in the context of cervical cancer screening.
Method: In-depth interviews generating qualitative data were carried out with 74 women participating in HPV testing in England between June 2001 and December 2003. Purposive sampling was used to ensure heterogeneity in age, ethnic group, marital status, socioeconomic background, cytology, and HPV results among participants.
Results: Testing positive for HPV was associated with adverse social and psychological consequences, relating primarily to the sexually transmitted nature of the virus and its link to cervical cancer. Women described feeling stigmatised, anxious and stressed, concerned about their sexual relationships, and were worried about disclosing their result to others. Anxiety about the infection was widespread, but the impact of testing positive varied. The psychological burden of the infection related to women’s relationship status and history, their social and cultural norms and practices around sex and relationships, and their understanding of key features of HPV.
Conclusion: HPV testing should be accompanied by extensive health education to inform women and to de-stigmatise infection with the virus to ensure that any adverse impact of the infection on women’s wellbeing is minimised.
- CIN, cervical intraepithelial neoplasia
- GPs, general practitioners
- HPV, human papillomavirus
- STI, sexually transmitted infections
Funding: The study was funded by Cancer Research UK.
Competing interest: All authors declare that there are no competing interests.
Ethical approval: The study was approved by the North and West Multi-Centre Research Ethics Committee and local ethics committees for each centre.