Knowledge of, attitudes towards and psychosocial impact of cervical screening, HPV infection, testing and vaccination

Cervical cancer is the second most common female malignancy worldwide. There are approximately 200 new cases diagnosed and 70 deaths annually in Ireland. A number of factors are known to be associated with increased risk of cervical cancer including smoking and infection with human papilloma virus (HPV). HPV infection is very common in Ireland and 70-80% of women will be infected at some stage in their life. In most cases infection lasts only a few months before it is cleared by the woman’s own immune system. However the infection persists in a small percentage of women and these women are at increased risk of cervical cancer. The disease is characterised by a well-defined pre-malignancy phase making early detection possible with modern cytology screening methods. A national cervical screening programme, CervicalCheck, was introduced in Ireland in 2008. The introduction of screening programmes in other countries has seen a dramatic decrease in cervical cancer incidence and mortality rates in the population. A school-based HPV vaccination programme was implemented in 2010, offering free vaccination against HPV for girls aged 12-13 years. More recently, testing for HPV infection was introduced in colposcopy clinics to help in the management of women with abnormal cervical cytology.

Under the auspices of the CERVIVA research consortium, researchers at the National Cancer Registry (www.ncri.ie(link is external)) aimed to investigate attitudes and psychological impact of screening, HPV infection and vaccination. This research comprised:

• A postal survey of women’s attitudes towards cervical screening, cervical cancer, HPV vaccination and HPV testing
• Focus groups in women to assess women’s attitudes, knowledge and practices with regard to cervical screening and HPV testing and vaccination
• In-depth, face-to-face, interviews with women who had an HPV DNA test performed at a colposcopy clinic in order to understand the psychological impact of HPV testing on women
• A longitudinal survey of the psychological impact of colposcopy and related interventions on women over a 12 month follow-up period
• A postal survey amongst general practitioners (GPs) to provide evidence-based information to support education and outreach programmes that increase awareness among GPs of screening, HPV infection and HPV vaccination

Some of the findings from these studies have been written up and published in peer-reviewed scientific journals (see the publications section of this website). Other findings are currently being written up for publication in suitable journals.

The ultimate aim of this research is to improve cervical screening experiences for women.