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Testing key messages about extending cervical screening intervals

Objectives: We tested the impact of different messages about the rationale for extended screening intervals on acceptability of an extension. Methods: Women in England aged 25-49 years (n=2931) were randomised to read different messages about extending intervals from 3 to 5 years. Outcome measures were general acceptability and six components from the Theoretical Framework of Acceptability (TFA). Results: The control group were less likely to find the change acceptable (43%) than the groups who saw additional messages (47-63%). Women who saw messages about interval safety, test accuracy or the speed of cell changes had more positive affective attitudes, higher ethicality beliefs, a better understanding of the reasons for the interval change and were more likely to believe that 5-year intervals would be safe. Being up-to-date with screening and previous abnormal results were associated with finding 5-yearly screening unacceptable. Conclusions: Emphasising the slow development of cell changes following an HPV negative result and the safety of longer intervals, alongside messages about the accuracy of HPV primary screening is important. Practical implications: Campaigns explaining the rationale for increased screening intervals are likely to improve acceptability. Though some women who feel at increased risk, may remain worried even when the rationale is explained.