Introduction Opportunities for tailored cervical cancer (CC) screening raise challenges in informed decision-making in HPV vaccination and screening. This study aimed to design decision- relevant risk communication about the relation between HPV-vaccination and CC screening.

Methods Six co-creation sessions involving parents (n=5) of daughters aged 7–10 and women (n=8) aged 24–30, with varying levels of health literacy, socioeconomic status, and ethnic background, were conducted. Participants engaged in creative assignments and evaluated prototypes of visualisations encompassing 1) risk information on CC and vaccine efficacy; 2) causes of CC; and 3) adapted screening intervals. Notes, transcripts, assignments, and session materials were thematically analysed.

Results Parents and women expressed preferences for both numerical information and narrative elements. Misconceptions emerged regarding the link between HPV and CC, as well as the vaccine’s mechanisms in reducing this risk. While parents considered numbers as a motivation for vaccination, women emphasized that numbers played a minor role in decision-making in screening. Women actively sought (numerical) data that heightens the sense of urgency for participation. Several visualisations and choice of numbers (absolute/relative risk information) were presented to participants. Participants frequently stated that absolute information and bar graphs made the risk of cervical cancer appear higher. Among various options, a population diagram emerged as the most suitable method for presenting risk information on cervical cancer and vaccine efficiency.

Discussion The role of numerical risk information seemed to differ for women and parents, possibly due to differences in decision-making between screening participation and parental vaccination choices. In vaccination decisions, parents weigh both the risk and benefits of the vaccine, while women, in their decision-making, seem to overlook potential harms of screening.

Conclusion It is imperative to ensure that the provided risk information aligns with the perception of the target audience and with the decision-making processes, while addressing any prevalent misconceptions.