Hywel Dda University Health Board
160 cases of cervical cancer are diagnosed in Wales each year. It is the most common cancer in women under the age of 35 years, yet only 7 in 10 eligible people in the UK attend screening, the lowest rate in 20 years. The Human papillomavirus (HPV) causes most cases of cervical cancer. Currently HPV testing is performed ‘in-person’ at a GP or sexual-health clinic as part of the national cervical-screening programme. Barriers exist which prevent people from having this test and evidence shows >50% of people if given a choice would prefer HPV self-sampling to in-person testing. Self -sampling is already available in Australia and The Netherlands and has been shown to be as effective at detecting HPV as in-person tests.
This project will develop a shared decision-making (SDM) tool that will support people to take a HPV self-sample. This will be incorporated within the national, freely available online sexual infection screening platform called ‘Test and Post’ (TAP). Service users will be provided with information to help them consider what matters most to them in relation to the possible outcomes of an HPV test, including doing nothing. Once built the tool will be piloted across different sites in Hywel Dda University.
- Co-production of the SDM tool with key partners and stakeholders including patients
- Testing and evaluation of the SDM tool with service users
- Further evaluation with health professionals and consider how it can be integrated into the current and online models
- Share results with key stakeholders and PPI via national conferences and use the results to feed into a larger feasibility study
The SDM tool will support informed choice around HPV testing, and improve knowledge and understanding of HPV and cervical cancer. The test will be available 24/7, 365 days of the year supporting greater accessibility and convenience for eligible people.
The group engaged a range of stakeholders including Cervical Screening Wales to support this project. Several service users were initially interviewed about their views on cervical smear testing and the potential for self-testing. A questionnaire was then developed, asking women about their understanding and behaviour regarding cervical smear testing and HPV. This was sent to women across HDUHB with over 4000 responses received. This data is currently being analysed and will inform the content of a short video which will be created as part of the SDM tool.