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226 The role of HPV vaccination status on future cervical cancer screening decisions and attitudes towards adapted intervals: a qualitative study among women and experts in the Netherlands
  1. Marlon Rolink1,
  2. Danielle RM Timmermans2,
  3. Mirjam P Fransen1
  1. 1Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
  2. 2Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands

Abstract

Introduction Future developments in HPV vaccination, cervical cancer (CC) screening, and opportunities for tailored intervals raise questions about information provision. The study aimed to explore how HPV vaccination status influences women’s decision-making for screening, examining beliefs about adapting screening intervals and comparing them to expert opinions.

Methods Semi-structured interviews (n=30) were conducted in the Netherlands with women aged 21– 29, who received HPV vaccination offers during childhood. Their conceptions were qualitatively analyzed and compared to an expert model derived from literature and interviews (n=10).

Results In the beliefs of women, a potential link between vaccination and screening was lacking. Women assumed that vaccinated women faced the same CC risk as unvaccinated women. Most emphasized the importance of routine screening. Reasons for maintaining screening, regardless of vaccination status, included beliefs in vaccine effectiveness, duration of protection, and the etiology of CC. Women were generally unaware of potential screening harms. Experts emphasized the clear link between vaccination and screening. They asserted that vaccine effectiveness reduces cancer risk, justifying adapted intervals to prevent overtreatment and screening harms. Factors mentioned by women that may influence the acceptability of adapted intervals included risk perception of CC, trust in the government and understanding of lower CC risk post-vaccination. Organizational factors, such as providing the option to undergo an additional screening test or interval length were also mentioned by women.

Discussion There were differences between the conceptions of the target group and experts regarding the link between vaccination and screening. Explicitly considering factors deemed significant by the target group is essential, such as the etiology of CC by clarifying the non-genetic origin as it stems from an HPV infection.

Conclusion Risk communication should aim for a coherent understanding among women regarding the relationship between vaccination and screening using a comprehensive framework encompassing HPV, vaccination, CC, and screening.

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