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What influences cervical screening uptake in older women and how can screening programmes translate this knowledge into behaviour changing strategies? A qualitative and quantitative research project

Each year, about 295 women in Ireland are diagnosed with cervical cancer. Smear tests/cervical screening is an effective way to reduce the risk of getting cervical cancer. CervicalCheck the national cervical cancer screening programme offers free smear tests to women aged 25 – 65 years. However, some women, particularly women over 50, do not attend for these important tests.
In this research study, we aim to identify factors that influence womens decisions on cervical screening (non)‐participation. The ultimate goals are to maximise cervical screening coverage in Ireland and provide information on women’s understanding of cervical screening in order to optimise screening effectiveness and deliver health gains for individual women and the population. The study will be conducted in 3 phases.
Phase 1 of this study uses qualitative interviews to explore womens views and understanding of cervical screening in Ireland. This phase has been completed.
Phase 2 of this study seeks to determine, by means of a population postal survey, the most important influences on attendance for cervical screening among older women and the inter-relationships between these influences. This phase is currently underway.
Phase 3 will use evidence gathered from phases 1 and 2 to conduct behavioural analysis and so form solutions to the problem of low screening coverage in older women.
Project Partners/collaborators: Trinity College Dublin (Lead), CervicalCheck, The National Cervical Screening Programme, Newcastle University.
Funding: Health Research Board, Ireland.

Head and Neck Cancer

CERVIVA is now looking into HPV associated cancers beyond the cervix. It is increasingly recognised that HPV is involved in the development of other cancers, including some head and neck cancers. Incidence of Head and neck cancer has been increasing over the last decade. Smoking tobacco and drinking alcohol are known risk factors but head and neck cancer is rising in younger people and among females, who are less likely to have strong histories of tobacco or alcohol use, suggesting the importance of HPV in these groups.

Health Economics

The health economics research theme within CERVIVA has a particular focus on cost-effectiveness analysis (CEA). CEA involves estimating the all the costs and health benefits that flow from a healthcare intervention and choosing the programme that maximises health gain for a given health budget. Applying CEA to screening for early stage disease involves comparing alternative testing technologies, considering how often to screen people and at what ages to start and stop screening. The goal this research is to find the most effective cervical screening strategy possible with acceptable resource demands on the Irish health system.

Health Psychology

Health psychology examines the role of psychological factors in the cause, progression and consequences of health and illness. The aims of health psychology can be categorised into (1) understanding, explaining, developing and testing theory, and (2) putting this theory into practice. CERVIVA is using health psychology to help understand women’s knowledge of, and attitudes towards, cervical screening and HPV. We are also using health psychology to investigate the psychological impact of cervical screening and follow-up of abnormal cervical cytology. The ultimate aim of this research is to improve cervical screening experiences for women.

Molecular Epidemiology

Molecular epidemiology focuses on investigating the role of abnormal changes at the cellular level and their contribution to disease prevalence in the population. Through molecular epidemiology we can improve our understanding of cervical cancer and pre-cancer by identifying how genetic and environmental factors influence the development of disease. A better understanding of the underlying mechanisms of cervical cancer development will aid in risk prediction and ultimately lead to advances in cervical cancer prevention.

New Technologies

The CERVIVA new technologies theme is focussed on developing new diagnostic and prognostic tests/technologies for use in cervical screening and cervical cancer pre-cancer diagnostics. We are adopting state-of-the-art approaches and technologies including proteomics, nanotechnology, spectroscopy, imaging, lab-on-a chip, and biochips to develop improved personalised medicine approaches for screening and cervical pre-cancer/cancer diagnostics. We collaborate with national and international partners in this regard through EU FP7, H2020 funded initiatives.