'I don't care whether it's HPV or ABC, I just want to know if I have cancer.' Factors influencing women's emotional responses to undergoing human papillomavirus testing in routine management in cervical screening: a qualitative study

BJOG. 2014 Oct;121(11):1421-9. doi: 10.1111/1471-0528.12741. Epub 2014 Apr 1.


Objective: To explore emotional responses, and predictors of negative reactions, among women undergoing human papillomavirus (HPV) tests in routine clinical practice.

Design: Exploratory qualitative interview study.

Setting: A large busy colposcopy clinic in a Dublin hospital.

Sample: Twenty-seven women who had had an HPV DNA test in the previous 6 months following one or more low-grade cytology tests or treatment for cervical intraepithelial neoplasia (CIN).

Methods: In-depth semi-structured interviews were conducted. Interview transcripts were analysed using a thematic approach (Framework Analysis).

Main outcome measures: Women's emotional responses and predictors of negative emotional reactions.

Results: For most women, having a test for high-risk HPV types generated little negative or positive emotional impact. Adverse emotional responses related to HPV infection rather than testing. Factors that influenced whether women experienced negative emotional responses were: concerns over abnormal cytology or diagnosis of CIN; HPV knowledge; awareness of HPV being sexually transmitted; awareness of HPV prevalence; and HPV information needs. Women's concerns about abnormal cytology/CIN dominated all other issues.

Conclusions: These qualitative data suggest that in the context of follow up of abnormal cytology or treatment for CIN, the emotional impact of HPV testing may be modest: women's primary concerns at this time relate to abnormal cytology/CIN.

Keywords: Abnormal cytology; cervical intraepithelial neoplasia; cervical screening; emotional responses; human papillomavirus testing; qualitative.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anxiety*
  • Cervical Intraepithelial Neoplasia / diagnosis
  • Cervical Intraepithelial Neoplasia / psychology*
  • Colposcopy* / psychology
  • Counseling
  • Emotions
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Ireland
  • Mass Screening / psychology
  • Middle Aged
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / psychology*
  • Precancerous Conditions / psychology
  • Predictive Value of Tests
  • Qualitative Research
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / psychology*
  • Vaginal Smears / methods