NL
DE
Since 2017, the cervical cancer screening programme in the Netherlands uses high-risk human papillomavirus (hrHPV) testing as the primary test. This has resulted in twice as many women being referred and an increased number of biopsies and control smears, leading to anxiety and increased costs. Using additional sociodemographic and lifestyle risk factors to triage women after a hrHPV-positive result may help limit the burden of unnecessary follow-up.
The PREFER project has three aims. The first aim is to determine the acceptability of additional risk profiling in focus groups. Next we will create risk profiles based on questionnaire and screening history data, among hrHPV-positive women. The last aim is to determine optimal triage scenarios for hrHPV-positive women using a microsimulation model.
The PREFER team recently completed the first part of the project in which we investigated the acceptability of risk-based triage in the target population. A total of 28 women eligible for cervical cancer screening participated in seven online focus group discussions. The analysis resulted in the identification of five main themes and 17 subthemes that determine the acceptability of risk-based triage. The main themes are: 1) adequacy of the screening program: an evidence-based program that is able to minimize cancer incidence and reduce unnecessary referrals; 2) personal information (e.g., sensitive topics and stigma); 3) emotional impact: fear and reassurance; 4) communication (e.g., transparency); and 5) autonomy (e.g., prevention). These themes highlight the challenges regarding the development and implementation of risk-based triage that need attention in order to be accepted by the target group. These challenges include dealing with sensitive topics and a transparent communication strategy.
As a next step, the PREFER team is currently collecting data on risk factors for cervical abnormalities from a population of women who previously had a positive hrHPV test result in cervical cancer screening. Recruitment of participants takes place via the screening organisation, gynaecologists, general practitioners, and a social media campaign (see figure 1 for an example of the advertisements).
Fig. 1. Example of social media advertisement.
Read the study here
Bas S, Sijben J, Bischoff EWMA, Bekkers RLM, de Kok IMCM, Melchers WJG, et al. (2023) Acceptability of risk-based triage in cervical cancer screening: A focus group study. PLoS ONE 18(8): e0289647. https://doi.org/10.1371/journal.pone.0289647
