Tatar Ovidiu, Haward Ben, Perez Samara, Zhu Patricia, Brotherton Julia, Decker Kathleen, Lofters Aisha K, Mayrand Marie-Hélène, McBride Emily, Ogilvie Gina, Shapiro Gilla K, Smith Laurie W, Steben Marc, Waller Jo, Zimet Gregory D, Rosberger Zeev
Lady Davis Institute for Medical Research, McGill University, Jewish General Hospital, Montreal, QC, Canada.
Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Lancet Reg Health Am. 2024 Oct 15;39:100901. doi: 10.1016/j.lana.2024.100901. eCollection 2024 Nov.
HPV test-based primary cervical screening is replacing cytology in Canada. In other countries, women's unpreparedness and concerns hindered the transition and post-implementation screening uptake. We investigated psychosocial correlates of intentions of screening in eligible individuals to participate in HPV-based primary cervical screening.
We conducted a nationwide web-based survey of individuals aged 21-70 years in 2022 and oversampled under-screened individuals. We used five Canadian-validated scales to measure HPV test-based screening knowledge, attitudes, and beliefs. Using the multistage Precaution Adoption Process Model, we assessed women's stage of intentions to participate in HPV testing and self-sampling. We estimated associations of psychosocial factors with intentions' stage using multinomial logistic regression.
In both groups (adequately screened n = 1778; under-screened n = 1570), higher HPV knowledge was associated with intention for HPV testing and more personal barriers to the HPV test were associated with lower intentions to participate in HPV testing or use of self-sampling. In both groups, higher self-sampling concerns were associated with lower intentions for self-sampling and higher women's need for autonomy was associated with increased intentions for self-sampling. In the under-screened group, increased age was associated with lower intentions for HPV testing and self-sampling, while living in Canada for <10 years was associated with higher intentions.
Our results could be used by policymakers and healthcare professionals to design communication strategies and ensure a smooth transition to HPV-based primary cervical screening, especially for under-screened individuals.
Canadian Institutes of Health Research project grant 165905.
在加拿大，基于人乳头瘤病毒（HPV）检测的宫颈癌初筛正在取代细胞学筛查。在其他国家，女性的准备不足和担忧阻碍了这一转变以及实施后的筛查参与率。我们调查了符合条件的个体参与基于HPV的宫颈癌初筛意愿的心理社会相关因素。
2022年，我们在全国范围内对21至70岁的个体进行了基于网络的调查，并对筛查不足的个体进行了过度抽样。我们使用了五个经过加拿大验证的量表来衡量基于HPV检测的筛查知识、态度和信念。使用多阶段预防采用过程模型，我们评估了女性参与HPV检测和自我采样意愿的阶段。我们使用多项逻辑回归估计心理社会因素与意愿阶段之间的关联。
在两组中（筛查充分的n = 1778；筛查不足的n = 1570），较高的HPV知识与HPV检测意愿相关，而HPV检测的更多个人障碍与参与HPV检测或使用自我采样的较低意愿相关。在两组中，较高的自我采样担忧与较低的自我采样意愿相关，而女性较高的自主需求与较高的自我采样意愿相关。在筛查不足的组中，年龄增加与HPV检测和自我采样的较低意愿相关，而在加拿大居住<10年与较高的意愿相关。
我们的结果可供政策制定者和医疗保健专业人员用于设计沟通策略，并确保顺利过渡到基于HPV的宫颈癌初筛，特别是对于筛查不足的个体。
加拿大卫生研究院项目资助165905。
