Print and online newspaper coverage of the link between HPV and oral cancer in the UK: a mixed-methods study

OBJECTIVES: The role of human papillomavirus (HPV) in some oral cancers has been reported in the news press, though little is known about the content of these articles. This study aimed to examine how frequently the link between HPV and oral cancer has been reported in the news press and to examine the content of these articles. DESIGN: UK media articles were searched for articles relating to oral cancer and HPV in the database NexisUK. Of 854 articles identified by the initial search, 112 were eligible for inclusion (2002-2014) and content analysis was used to determine the main themes discussed. RESULTS: Themes included actor Michael Douglas' claim that his throat cancer was caused by HPV, the riskiness of oral sex, health information (including HPV as a cause of oral cancer) and the need to vaccinate boys against HPV. Many articles also referred to the link between HPV and cervical cancer and the increasing incidence of HPV-related oral cancer. The largest peak in articles occurred when Michael Douglas discussed his cancer (June 2013). Facts about HPV and references to research were provided in some articles. CONCLUSIONS: The link between HPV and oral cancer and the transmission of HPV via oral sex was regularly discussed, yet coverage often lacked detailed health information. This could increase awareness of the link between oral sex and HPV risk, but may also lead to public concern about oral sex as a sexual behaviour

Attitudes towards lung cancer screening in socioeconomically deprived and heavy smoking communities: informing screening communication

BACKGROUND: While discussion continues over the future implementation of lung cancer screening, low participation from higher risk groups could limit the effectiveness of any national screening programme. OBJECTIVES: To compare smokers' beliefs about lung cancer screening with those of former and never smokers within a low socioeconomic status (SES) sample, to explore the views of lower SES smokers and ex-smokers in-depth, and to provide insights into effective engagement strategies. DESIGN, SETTING AND PARTICIPANTS: Using proactive, community-based recruitment methods, we surveyed 175 individuals from socioeconomically deprived communities with high smoking prevalence and subsequently interviewed 21 smokers and ex-smokers. Participants were approached in community settings or responded to a mail-out from their housing association. RESULTS: Interviewees were supportive of screening in principle, but many were doubtful about its ability to deliver long-term survival benefit for their generation of "heavy smokers." Lung cancer was perceived as an uncontrollable disease, and the survey data showed that fatalism, worry and perceived risk of lung cancer were particularly high among smokers compared with non-smokers. Perceived blame and stigma around lung cancer as a self-inflicted smokers' disease were implicated by interviewees as important social deterrents of screening participation. The belief that lungs are not a treatable organ appeared to be a common lay explanation for poor survival and undermined the potential value of screening. CONCLUSIONS: Attitudes towards screening among this high-risk group are complex. Invitation strategies need to be carefully devised to achieve equitable participation in screening

Experiences of cervical screening and barriers to participation in the context of an organised programme: a systematic review and thematic synthesis

OBJECTIVE: As uptake of cervical screening continues to decline, this systematic review synthesises the qualitative literature on women's perceptions and experiences of cervical screening in the context of an organised call-recall programme, in order to understand the barriers to informed uptake. METHODS: We searched nine databases for English language peer-reviewed publications reporting on qualitative data from screening-eligible women, exploring barriers to cervical screening in countries that offer a nationally organised call-recall programme. Evidence was integrated using thematic synthesis. RESULTS: Thirty-nine papers from the UK, Australia, Sweden and Korea were included. The majority of participants had attended screening at least once. Two broad themes were identified: (a) should I go for screening? and (b) screening is a big deal. In considering whether to attend, women discussed the personal relevance and value of screening. Women who had previously attended described how it was a big deal, physically and emotionally, and the varied threats that screening presents. Practical barriers affected whether women translated screening intentions into action. CONCLUSIONS: The variation in women's understanding and perceptions of cervical screening suggests that interventions tailored to decisional stage may be of value in increasing engagement with the invitation and uptake of screening in those who wish to take part. There is also a need for further research with women who have never attended screening, especially those who remain unaware or unengaged, as their perspectives are lacking in the existing literature. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd

Exploring Human Papillomavirus Vaccination Refusal Among Ethnic Minorities in England: A Comparative Qualitative Study.

OBJECTIVES: In England, uptake of human papillomavirus (HPV) vaccination to prevent HPV-related cancer is lower among girls from ethnic minority backgrounds. We aimed to explore the factors that prevented ethnic minority parents from vaccinating, compared to White British non-vaccinating parents and vaccinating ethnic minority parents. METHODS: Interviews with 33 parents (n = 14 ethnic minority non-vaccinating, n = 10 White British non-vaccinating, n = 9 ethnic minority vaccinating) explored parents' reasons for giving or withholding consent for HPV vaccination. Data were analysed using Framework Analysis. RESULTS: Concerns about the vaccine were raised by all non-vaccinating ethnic minority parents, and they wanted information to address these concerns. External and internal influences affected parents' decisions, as well as parents' perceptions that HPV could be prevented using means other than vaccination. Reasons were not always exclusive to non-vaccinating ethnic minority parents, although some were, including a preference for abstinence from sex before marriage. Only ethnic minority parents wanted information provided via workshops. CONCLUSIONS: Ethnic differences in HPV vaccination uptake may be partly explained by concerns that were only reported by parents from some ethnic groups. Interventions to improve uptake may need to tackle difficult topics like abstinence from sex before marriage, and use a targeted format

Could changing invitation and booking processes help women translate their cervical screening intentions into action? A population-based survey of women's preferences in Great Britain

Objectives Many women who do not attend screening intend to go, but do not get around to booking an appointment. Qualitative work suggests that these ‘intenders’ face more practical barriers to screening than women who are up-to-date (‘maintainers’). This study explored practical barriers to booking a screening appointment and preferences for alternative invitation and booking methods that might overcome these barriers. Design A cross-sectional survey was employed. Setting Great Britain. Participants Women aged 25–64, living in Great Britain who intended to be screened but were overdue (‘intenders’, n=255) and women who were up-to-date with screening (‘maintainers’, n=359). Results ‘Intenders’ reported slightly more barriers than ‘maintainers’ overall (mean=1.36 vs 1.06, t=3.03, p<0.01) and were more likely to think they might forget to book an appointment (OR=2.87, 95% CI: 2.01 to 4.09). Over half of women said they would book on a website using a smartphone (62%), a computer (58%) or via an app (52%). Older women and women from lower social grades were less likely to say they would use online booking methods (all ps <0.05). Women who reported two or more barriers were more likely to say they would use online booking than women who reported none (ps <0.01). Conclusions Women who are overdue for screening face practical barriers to booking appointments. Future interventions may assess the efficacy of changing the architecture of the invitation and booking system. This may help women overcome logistical barriers to participation and increase coverage for cervical screening

Human Papillomavirus and Head and Neck Cancer: Psychosocial Impact in Patients and Knowledge of the Link - A Systematic Review

Head and neck cancer (HNC) currently affects approximately 11 200 people in the UK, with an increasing proportion known to be caused by the human papillomavirus (HPV). We undertook a systematic review of studies measuring the psychosocial impact of HPV-related HNC and also studies measuring knowledge about the link between HPV and HNC among different populations. Searches were conducted on MEDLINE, Embase, PsycINFO, CINAHL Plus and Web of Science, with reference and forward citation searches also carried out on included studies. Studies were selected if they (i) were original peer-reviewed research (qualitative or quantitative), (ii) mentioned HPV and HNC, (iii) measured an aspect of the psychosocial impact of the diagnosis of HPV-related HNC as the dependent variable and/or (iv) measured knowledge of the association between HPV and HNC. In total, 51 papers met the inclusion criteria; 10 measuring psychosocial aspects and 41 measuring knowledge of the link between HPV and HNC. Quality of life in those with HPV-positive HNC was found to be higher, lower or equivalent to those with HPV-negative HNC. Longitudinal studies found quality of life in patients was at its lowest 2-3 months after diagnosis and some studies found quality of life almost returned to baseline levels after 12 months. Knowledge of the link between HPV and HNC was measured among different populations, with the lowest knowledge in the general population and highest in medical and dental professionals. Due to the limited studies carried out with patients measuring the psychosocial impact of a diagnosis of HPV-positive HNC, future work is needed with the partners of HPV-positive HNC patients and health professionals caring for these patients. The limited knowledge of the association between HPV and HNC among the general population also indicates the need for research to explore the information that these populations are receiving

The Jade Goody Effect: whose cervical screening decisions were influenced by her story?

In 2009 more women attended cervical screening in England and Wales than in the previous year. Described as the 'Jade Goody Effect' this was attributed to the death from cervical cancer of a UK celebrity. The present study aimed to establish which sociodemographic characteristics were associated with being influenced by Jade Goody's story

Predicting human papillomavirus vaccination behaviour among adolescent girls in England: results from a prospective survey

To maximise the benefits of human papillomavirus (HPV) vaccination, uptake needs to be high. We examined psychosocial predictors of HPV vaccine uptake and the association between vaccine intention and uptake 1&emsp14;year later in adolescent girls (aged 16-17&emsp14;years) in England

Perceived risk of cervical cancer among pre-screening age women (18-24 years): the impact of information about cervical cancer risk factors and the causal role of HPV.

Current National Health Service cervical screening information does not explain that the cause of cervical cancer is a sexually transmitted infection (human papillomavirus (HPV)). This study aimed to consider the impact that providing this information, in addition to risk factor information, might have on women's perceived risk of cervical cancer