As more and more countries move to using primary HPV DNA testing in cervical screening, there is an increasing need to understand the psychological impact this change may have on women taking part in screening. A number of studies have found that testing positive for a sexually transmitted virus in the cancer screening context can be confusing and distressing, raising issues of stigma and shame which are less common responses to abnormal cytology results. This paper will describe the protocol of a study in England aimed at assessing psychological responses to different screening results in the context of primary HPV testing.
The Psychological Impact of Primary Screening (PIPS) study is a cross-sectional observational study being carried out in the context of pilot HPV primary screening in England. The study uses validated measures of anxiety, distress and quality of life to compare women receiving 6 different screening results: cytology negative (control group); HPV negative; HPV positive with normal cytology; HPV positive with abnormal cytology; persistently HPV positive with normal cytology; and HPV negative following a previous HPV positive result. Questionnaires are being used to assess a range of psychological constructs 2 weeks, 6 months and 12 months after women have received their screening results. Between-group differences and changes over time will be explored.
The PIPS study and other similar research will shed light on the psychological challenges faced by women having primary HPV testing and will point to ways in which communication strategies can be better designed to minimize adverse psychological responses. Measuring quality of life in such studies allows any adverse impact of HPV positive results to be included in health economic modelling of new screening algorithms. This paper is part of the session on “Identifying and Overcoming Communication Challenges”.