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35 Do we understand benefits and harms of medical screening? Information material focusing on informed choice, when invited to cervical cancer screening

Abstract

The benefits and harms of cervical cancer screening are delicately balanced, why participation should be based on an informed choice. In the process of obtaining informed consent information pamphlets play a central part, why adequate health and risk communication is essential. However, pamphlets on screening have been shown to be information poor and biased in favour of participation and little attention has been paid to how the pamphlets are understood. Therefore, the aim of this study was twofold: 1) to develop evidence-based information material on cervical cancer screening and 2) to investigate how women understand and interpret this information material. Semi-structured interviews with 17 women aged 23–55 years were carried out in two interview rounds. The transcribed interviews were initially analysed using theory of meaning condensation and the second order analysis was guided by the theory of cognitive dissonance. Generally the analysis revealed that the developed information succeeded in presenting understandable health and risk information on cervical cancer screening. However, the participants still struggled with the numerical risk information at times and their preconceptions about cervical cancer screening, lead them to focus on the benefits and downplay the harms. According to the cognitive dissonance theory the second finding points to the use of defence mechanisms, which creates a perception gap between the written information and the participants’ understanding and explanation of the information. Breaching the perception gap is necessary if we want to increase the possibility of making an informed choice about participation in cancer screening.

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