Harriet L. Bowyer

Knowledge and awareness of HPV and the HPV vaccine among young women in the first routinely vaccinated cohort in England

A national school-based human papillomavirus (HPV) vaccination programme has been available for 12-13 year old females in the UK since 2008, offering protection against HPV types 16 and 18, which are responsible for the majority of cervical cancer. Little is known about HPV knowledge in girls who have been offered the vaccine. Girls offered the school-based vaccine in the first routine cohort (n=1033) were recruited from 13 schools in London three years post-vaccination. Participants completed a questionnaire about HPV awareness, knowledge about HPV and the vaccine, and demographic characteristics including vaccine status. About a fifth of the girls reported they were unaware of the HPV infection. Among those who reported being aware of HPV (n=759) knowledge was relatively low. Approximately half of the participants knew that HPV infection causes cervical cancer, condoms can reduce the risk of transmission and that cervical screening is needed regardless of vaccination status. These results are helpful in benchmarking HPV-related knowledge in vaccinated girls and could be used in the development of appropriate educational messages to accompany the first cervical screening invitation in this cohort in the future.

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

Background 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 year later in adolescent girls (aged 16–17 years) in England. Method Adolescent girls in the catch-up cohort were recruited from colleges in the South East of England in 2009 and 2010. Participants completed a questionnaire 6 months before (n=606) and 6 months after (n=214) being offered the vaccine, which assessed vaccine intention, vaccine uptake, demographics and attitudes based on the Health Belief Model and Theory of Planned Behaviour. Results A number of demographic and psychological factors, including intention, showed associations with vaccine uptake in uni-variable analyses. In multi-variable analyses, only ethnicity was independently associated with vaccine uptake. Participants from Black or ‘Other’ ethnic backgrounds were less likely to have received the HPV vaccine than White participants. Conclusions More research is needed to help understand variation in vaccine coverage between ethnic groups.

Association between human papillomavirus vaccine status and other cervical cancer risk factors.

Highlights • Girls from black or ‘other’ ethnic backgrounds were less likely to be vaccinated than white girls.• Vaccine status was not associated with smoking status or sexual activity.• Unvaccinated girls had lower intentions to attend cervical screening in the future.

Patient attitudes towards faecal immunochemical testing for haemoglobin as an alternative to colonoscopic surveillance of groups at increased risk of colorectal cancer

Objectives To examine attitudes towards an annual faecal immunochemical test for haemoglobin (FIT) versus three-yearly colonoscopic surveillance of individuals at intermediate risk of colorectal cancer (CRC). Setting A London hospital. Methods Five semi-structured discussion groups were conducted with 28 adults (aged 60–74, 61% female) with different levels of CRC risk and experience of colonoscopy or colonoscopic surveillance. Information was presented sequentially using a step-by-step discussion guide. Results were analyzed using thematic analysis. Results When evaluating FIT in the context of a surveillance programme, all respondents readily made comparisons with related tests that they had been exposed to previously. Those with no experience of surveillance were enthusiastic about an annual FIT to replace three-yearly colonoscopy, because they felt that the higher testing frequency could improve detection of advanced lesions. Those with experience of colonoscopic surveillance did not perceive FIT to be as accurate as colonoscopy, and therefore either preferred colonoscopy on its own or wanted an annual FIT in addition to three-yearly colonoscopy. Conclusions FIT may be well-received as an additional method of surveillance for new patients at intermediate risk of CRC. More research is required to better understand potential barriers associated with FIT surveillance for patients with experience of colonoscopic surveillance.

PWE-034 Patient-reported Experience Of Comfort And Dignity In Flexible Sigmoidoscopy: Data From The Nhs Bowel Scope Screening Pilot

Introduction The NHS Bowel Cancer Screening Programme started flexible sigmoidoscopy (FS) screening (also known as Bowel Scope Screening, BSS) at six centres across England (Gateshead, Guildford, London, Medway, Norwich, Wolverhampton) in March 2013. The aim of this analysis was to investigate the extent to which high levels of patient satisfaction recorded in previous UK trials can be replicated in the early stages of a routine screening programme. Methods We used used data from an ongoing study monitoring patient-reported experience in the pilot phase of the BSS Programme. We report data from the ‘post-AM questionnaire’ which is given to patients at the end of their FS appointment and supposed to be completed on the following day. Results As of January 2014, we had received 2,324 questionnaires. Satisfaction with the test was high with 98.8% of patients being either satisfied (21.1%) or very satisfied (77.7%). Nonetheless, 43% of patients reported moderate (34%) or severe pain (9%) which was high compared with the St Marks’ demonstration programme1 and the UK Flexible Sigmoidoscopy Trial2 (Figure 1). Women were three times as likely to report severe pain during the test than men (14.3 vs 4.6%), and twice as likely to find the test as more painful than they had expected (39.9 vs 20.1% respectively). Only about 1 in 10 patients reported being moderately (9.8%) or severely (1.4%) embarrassed during the test, with women being slightly more likely than men to fall into these categories (13.4 vs. 8.9%). Women also had a much stronger preference for the test to be carried out by a female practitioner than men (41.2% vs 7.1% respectively). Abstract PWE-034 Figure 1 Patient-reported levels of pain Conclusion The vast majority of patients were satisfied with their experience of FS screening. However, levels of pain appear high when compared with previous trials. Emphasis should be placed on ensuring that patients have as comfortable a procedure as possible. Additional consideration should be given to women being able to choose the sex of the practitioner performing the test. References 1 Robb K, Lo S, Power E, et al. Patient-reported outcomes following flexible sigmoidoscopy screening for colorectal cancer in a demonstration screening programme in the UK. J Med Screen 2012;19:171–176 2 Taylor T, Williamson S, Wardle J, et al. Acceptability of flexible sigmoidoscopy screening in older adults in the United Kingdom. J Med Screen 2000;7:38–45 Disclosure of Interest None Declared.