Table 1.

Messages about HPV and the rationale for extended intervals.

Control group - Announcement messages only Cervical screening used to start by looking for abnormal cells in the cervix, but in 2019, the process changed. Nearly all cervical cancers are caused by a virus called human papillomavirus (HPV). The screening test itself is carried out in the same way as before but we now start by checking the sample for the types of HPV that can cause cervical cancer. This means we can make further changes to improve cervical screening for you. From 2021, people your age (25–49 years) will be invited for screening every 5 years instead of every 3 years.

Timeline message There are three steps in the development of cervical cancer. The first is infection with HPV. If your immune system does not get rid of the virus, HPV can cause the second step, abnormal cells. Thirdly, if the abnormal cells are not treated, they can turn into cancer. The development of HPV into cervical cancer is usually a slow process taking over 10 years.

If HPV Positive message If your sample is HPV positive (i.e. you have HPV), we will also check it for abnormal cervical cells. If none are found, you will be asked to come for screening again in 12-months. This is to check if your immune system has got rid of HPV. If you have HPV and abnormal cervical cells we will refer you for another examination.

Accuracy message Before HPV testing, screening would occasionally miss abnormal cells, so it was important for you to come for screening every 3 years in case this happened. The HPV test is better at picking up if you have HPV so you do not need to have screening as often.

Safety message If you have an HPV negative screening result (i.e. you do not have HPV), it is safe to wait five years until your next screen. Even if you have had abnormal cells before, or had treatment, it is still safe for you to have 5 yearly screening if you are HPV negative. You only need further tests if you have HPV.

Speed of cell changes message HPV progresses very slowly. This means any abnormal cells in the cervix that develop within the 5 years between your screening tests can still be treated when picked up at the next test. Having screening 3 years after a negative HPV result is usually too soon for cells in your cervix to become abnormal.

Note: All participants saw the ‘Announcement messages’