Ogilvie Gina S, Smith Laurie W, van Niekerk Dirk, Khurshed Fareeza, Pedersen Heather N, Taylor Darlene, Thomson Katharine, Greene Sandra B, Babich Suzanne M, Franco Eduardo L, Coldman Andrew J
University of British Columbia, Vancouver, BC, Canada.
Women's Health Research Institute, Vancouver, BC, Canada.
BMC Public Health. 2016 Mar 2;16:213. doi: 10.1186/s12889-016-2865-8.
High-risk HPV DNA testing has been proposed as a primary tool for cervical cancer screening (HPV-CCS) as an alternative to the Papanicolaou cytology- method. This study describes factors associated with women's intentions to attend cervical cancer screening if high-risk HPV DNA testing (HPV-CCS) was implemented as a primary screening tool, and if screening were conducted every 4 years starting after age 25.
This online survey was designed using the Theory of Planned Behaviour to assess factors that impact women's intentions to attend HPV-CCS among women aged 25-69 upon exit of the HPV FOCAL trial. Univariate and regression analyses were performed to compare the demographic, sexual history, and smoking characteristics between women willing and unwilling to screen, and scales for intention to attend HPV-CCS. A qualitative analysis was performed by compiling and coding the comments section of the survey.
Of the 981 women who completed the survey in full, only 51.4 % responded that they intended to attend HPV-CCS with a delayed start age and extended screening interval. Women who intended to screen were more likely to have higher education (AOR 0.59, 95 % CI [0.37, 0.93]), while both positive attitudes (AOR 1.26, 95 % CI [1.23, 1.30]) and perceived behavior control (AOR 1.06, 95 % CI [1.02, 1.10]) were significant predictors of intention to screen. Among women who provided comments in the survey, a large number of women expressed fears about not being checked more than every 4 years, but 12 % stated that these fears may be alleviated by having more information.
Acceptability of increased screening intervals and starting age could be improved through enhanced education of benefits. Program planners should consider measures to assess and improve women's knowledge, attitudes and beliefs prior to the implementation of new screening programs to avoid unintended consequences.
高危型人乳头瘤病毒（HPV）DNA检测已被提议作为宫颈癌筛查（HPV-CCS）的主要工具，以替代巴氏细胞学检查方法。本研究描述了如果将高危型HPV DNA检测（HPV-CCS）作为主要筛查工具，且从25岁开始每4年进行一次筛查，与女性参加宫颈癌筛查意愿相关的因素。
本在线调查采用计划行为理论设计，以评估在HPV FOCAL试验结束时影响25至69岁女性参加HPV-CCS意愿的因素。进行单因素分析和回归分析，以比较愿意和不愿意筛查的女性之间的人口统计学、性史和吸烟特征，以及参加HPV-CCS的意愿量表。通过汇编和编码调查的评论部分进行定性分析。
在981名完整完成调查的女性中，只有51.4%的人表示她们打算参加开始年龄延迟且筛查间隔延长的HPV-CCS。打算筛查的女性更有可能接受过高等教育（优势比0.59，95%置信区间[0.37, 0.93]），而积极态度（优势比1.26，95%置信区间[1.23, 1.30]）和感知行为控制（优势比1.06，95%置信区间[1.02, 1.10]）都是筛查意愿的重要预测因素。在调查中发表评论的女性中，大量女性表示担心每4年以上不进行检查，但12%的人表示，获得更多信息可能会减轻这些担忧。
通过加强对益处的教育，可以提高延长筛查间隔和开始年龄的可接受性。项目规划者应考虑在实施新的筛查项目之前采取措施评估和改善女性的知识、态度和信念，以避免意外后果。
