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Bevan Exemplar Cohort 8 Projects

Develop and pilot a shared decision making tool to support HPV self-sampling online

Helen Munro (HDUHB), Debbie Harvey (LSHW) and Zoe Couzens (PHW)

Hywel Dda University Health Board, Life Sciences Hub Wales and Public Health Wales

Project Background:

The Human Papillomavirus (HPV) is known to cause most cases of cervical cancer.

HPV testing is the primary test as part of routine cervical (smear) tests, which are offered every 5 years to eligible people in Wales.

Attendance at routine screening has declined over recent years, with Hywel Dda University Health Board (HDUHB) having the lowest attendance rates in Wales.

HPV self-sampling at home, could be a way to increase uptake of screening, and help prioritise those at greatest need of investigation and treatment.

Project Aims:

The main aim of the project was to survey eligible people in HDUHB about their understanding of HPV, their attendance at cervical screening, and their view of HPV self-sampling.

We used these survey results to help create resources to support decision making around cervical (smear) testing and HPV self-sampling.

We then carried out a thematic analysis and cost-benefit analysis with a view to supporting and shaping future cervical screening programmes.

Project Approach:

Collaboration between HDUHB, Life Sciences Hub Wales (LSHW), Public Health Wales (PHW) and Cervical Screening Wales (CSW) were key to delivering this project.

We used a mixed methods approach to impact assessment, using CIVICA software to survey eligible people, a qualitative thematic analysis and cost-benefit analysis.

We also field tested our decision aid using feedback which fed into new iterations (video).

Project Outcomes:

4623 people, aged 25-64 years, completed the online survey with 64% of respondents choosing a HPV self-sample at home if given a choice.

Convenience and comfort were reasons most commonly cited for taking a HPV self-sample at home. ​

Lack of confidence to self-administer the test was the most common reason for not choosing the HPV self-sample. ​

​Survey results highlighted there remains confusion about the link between HPV and cervical cancer, as well as HPV testing as part of cervical screening.

Project Impact:

Introducing HPV self-sampling in HDUHB has the potential to create resource savings of around £650,000 per year for the NHS.

Introduction of HPV self-sampling has the potential to create time savings for patients who opt for self-sampling over in-clinic sampling (valued at approximately £2 million per year).

It also has the potential to lead to an improvement in health outcomes for those patients who would otherwise not have been screened.

View the project poster and slides from the Cohort 8 Bevan Exemplar Showcase