Authors' objectives:

To know the information needs of women at all stages of the cervical cancer screening process and to draw up evidence-based recommendations regarding the timing, form and content of the written information that should be offered to facilitate informed participation in cervical cancer screening.

Authors' recommendations: Women have poor information, and in some aspects confused or erroneous, on cervical cancer screening. Relevant areas of improvement have been detected in the process of communication of the screening results and related to diagnostic tests. The quality of studies design included in the systematic review is limited. Further quality research into the process of written communication about cervical cancer screening is called for.Few studies on the written communication in the first stage of the screening have been recovered. The most studies focus on the process of communication of screening results and information on diagnostic tests. At present the majority of the Spanish autonomous communities have not written materials on cervical cancer screening, and the few available documents provide little or no information on relevant aspects of screening. In none of them, information about the screening risks has been offered.The invitation letter and/or leaflet should clearly express the objective of the screening and provide information on cervical cancer, target population, screening interval and screening test (purpose, procedure, validity, benefits, risks and results), diagnostic tests, treatment options and how to get more information.The presentation of risk information is complicated. There is important agreement that epidemiological data (incidence and mortality) should be expressed with constant denominators (3 per 10 000 women) to facilitate its understanding and that the use of pictograms facilitates risk understanding.To reduce the emotional impact that the abnormal results have on women, it would be advisable to provide written information before the screening test, explaining that do not mean cancer. High-quality information on HPV should be offered to improve understanding of the relationship between sexual behaviour, HPV, cytology and cervical cancer. This nformation should be available before the screening.The communication of any cytology result should be guarantee whether are normal as abnormal. Communication of a normal result should be accompanied by a sentence that would indicate that this means a low risk for developing cervical cancer in the next five years. It also should report what to do if a woman has symptoms. To reduce anxiety of women with inadequate cervical smear test results, it is recommended to give information on the high frequency of these test results and to inform on the absolute risk of developing cervical cancer, which is low.Due to strong emotional impact that abnormal results have on women, its meaning should be clearly explained at the time of communication of results.Women believe that screening test results must be communicated face to face by a health professional, especially when they should undergo diagnostic tests for asking questions and getting answers immediately.It is also recommended to complement oral information with written information that gives women the time to think about the situation. Some women want to have the possibility of access to more information through websites or specific telephone numbers to complement the received information or to consult their questions.When women have abnormal test results and are referred for colposcopy, written information on procedure should be provided at the time of receiving their abnormal test result. To provide written information of quality about colposcopy increases the level of knowledge, but not reduces anxiety.After undergoing colposcopy women may need additional information on their relationships with their partners: sexually transmitted infections, need to avoid temporary sexual intercourses, impact on fertility.In order to participate in the decision-making on the management of their cervical abnormalities women need to obtain the necessary information from their doctor.Medical language is an impenetrable barrier to many women. An effort should be made to offer information in such a way that women can understand it, by avoiding technical jargon. It is recommended to develop written materials with more information and adapted to suit the women needs at the different stages of the screening process.It is recommended that the characteristics of the printed materials comply with the recommendations from the tables 12 and 13 as far as possibleIt is recommended to take into account the users opinion for the draw up of information material.To ensure that information on cervix cancer screening come to the target population it is recommended to provide this information through multiple communication instrumentss redundantly: health professionals, printed materials, telephone lines, websites.In Spain it is necessary to draw up written materials that comply with the information model required to ensure informed participation in the screening and to cover the information needs of women at all stages of the screening process.It is recommended to offer training programmes to the health professionals responsible for communicating screening results, to enable them to identify the information needs of women and to acquire communication skills (counseling).With the introduction of new techniques and diagnostic tests in clinical practice it is recommended to draw up clinical practice guidelines for having clear and precise recommendations on the follow-up of cervical abnormalities.Due that some screening programmes and health centres are incorporating the HPV test as screening test and/or as diagnostic test, a separate and specific HPV leaflet should be produced, with information about the role of HPV in the cervical cancer and the meaning of the possible HPV test results.

Project Status: Completed

URL for project: http://www.sergas.es/MostrarContidos_N3_T02.aspx?IdPaxina=60056&uri=/docs/Avalia-t/avalia-t-Cribado-cervix.pdf&hifr=1250&seccion=0

Year Published: 2010

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)

Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;

Contact Name: avalia-t@sergas.es

Contact Email: avalia-t@sergas.es

Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)