ASPO Abstracts

Authors: Bustamante, G; McRee, AL; McNair, K; Fontenot, H

Category: Behavioral Science & Health Communication
Conference Year: 2021

Abstract Body:
Purpose Current risk-based guidelines for cervical cancer screening (CCS) allow for individualized screening that minimizes unnecessary testing. However, these guidelines are complex and may not be easily understandable which could lead to confusion among women. We aimed to understand women's knowledge and preferences about CCS in light of recent guideline changes and examine if differences exist across race and ethnicity. Methods We conducted four online text-based focus groups with a national sample of women aged 27-45 years (n=49) in February 2020. Participants were recruited via InsideHeads, LLC, a market research company. After completing a short demographic survey, an experienced moderator used a semi- structured guide to solicit participants' perceptions of routine gynecologic care and CCS. We summarized survey data using descriptive statistics. Two authors analyzed transcripts using conventional content analysis including initial coding and collapsing codes into broader themes. A third author reviewed codes and resolved any intercoder discrepancies. The entire research team agreed on final themes. Results The majority of women were white (65%) and had health insurance (90%). Most women reported having a routine gynecological exam in the past year (70%), and believed they were up-to-date on their CCS (83%). We identified four common themes: (1) low perceived risk of human papillomavirus (HPV) coupled with low knowledge about HPV as a causative factor for cervical cancer; (2) confusion about--and mistrust of--recent individual risk-based guidelines that determine the indicated type of test (Pap or HPV) and timing for CCS; (3) mixed opinions related to a potential future option to perform a self-swab hrHPV test; and (4) provider recommendation was important for some women, but others voiced substantial distrust towards providers and the healthcare industry. Themes were similar across race and ethnicity. Conclusions Findings highlight women's confusion and mistrust about current CCS guidelines. Effective communication strategies should: consider women's gaps in knowledge about the role of HPV in cancer; include the rationale for changes in guidelines and types of tests available; and build trust between patients and providers.

Keywords: cervical cancer, screening, women, confusion

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