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Assessing the Role of Education in Women's Knowledge and Acceptance of Adjunct High-Risk Human Papillomavirus Testing for Cervical Cancer Screening

Papa, Debra MD1; Moore Simas, Tiffany A. MD, MPH1,2; Reynolds, Megan MD3; Melnitsky, Hannah4

Journal of Lower Genital Tract Disease: April 2009 - Volume 13 - Issue 2 - p 66-71
doi: 10.1097/LGT.0b013e31818a53f0

Objective. To assess women's knowledge, concerns, and willingness for adjunct high-risk human papillomavirus (HR-HPV) testing before and after an educational intervention.

Materials and Methods. At the time of their annual gynecologic examination, women aged 30 years and older received an educational intervention about HR-HPV. Subjects completed preintervention and postintervention questionnaires. Demographic characteristics were summarized using frequency measures. Comparisons between the pre-education and posteducation questionnaires were performed using Fisher exact test.

Results. Fifty women completed the study. After the educational intervention, 77% of women were willing to be tested for HR-HPV. Sixty-seven percent of women would be likely to return for their annual gynecologic examination even if a Pap smear was not required for 3 years. Education statistically reduced concern regarding a positive HR-HPV result with 60% pre-education and 27% posteducation very concerned (p =.002). When surveyed about what their concerns would be if tested positive for HR-HPV, women associate future cervical cancer diagnosis (38% pre-education vs 48% posteducation, p =.903) but not partner infidelity (0%) with testing positive for HR-HPV. Knowledge concerning HPV, cervical cancer, and cervical cancer screening was statistically improved after the educational intervention in all but 2 questions.

Conclusion. Women 30 years and older are willing to have adjunct HR-HPV testing, with education reducing their degree of concern about testing positive. Women who test positive would be most concerned about getting cervical cancer. Women would be willing to return for yearly gynecologic examinations, even if a Pap smear was not needed for 3 years. Education improves women's knowledge of HPV, cervical cancer, and cervical cancer screening, but did not allay the concern for getting cervical cancer.

Women are willing to be tested for high-risk human papillomavirus and would be most concerned about developing cervical cancer if they test positive.

1Departments of Obstetrics and Gynecology, and 2Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA; 3Department of Obstetrics and Gynecology, Brown University and Women and Infants Hospital of Rhode Island, Providence, RI; and 4University of Massachusetts Medical School, Worchester, MA

Reprint requests to: Debra Papa, MD, Department of Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Memorial Campus, 119 Belmont St, Worcester, MA 01605. E-mail:

©2009The American Society for Colposcopy and Cervical Pathology