Examining the psychosexual impact of human papillomavirus testing in routine cervical screening

检查人乳头瘤病毒检测在常规宫颈筛查中对性心理的影响

基本信息

批准号：
1764915
负责人：
金额：
--
依托单位：
University College London
依托单位国家：
英国
项目类别：
Studentship
财政年份：
2016
资助国家：
英国
起止时间：
2016 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=studentship-1764915
关键词：
Examining psychosexual impact human papillomavirus

项目摘要

The NHS Cervical Screening Programme aims to prevent cancer by detecting and treating abnormalities of the cervix. Cytology is currently used to detect cervical abnormalities with testing for human papillomavirus (HPV) if cytology results show borderline or low-grade abnormal cell changes. HPV is a highly prevalent sexually transmitted infection and nearly all cases of cervical cancer can be attributed to HPV infection. Research suggests that using HPV testing as the primary test in cervical is more sensitive for detecting high grade precancerous disease. The NHS Cervical Screening Programme is now using HPV testing as the primary test in six sites in England with the intention of rolling this out across the whole of England by 2019. Previous research evaluating the impact of HPV testing in cervical screening suggests that an HPV positive result has an adverse psychosocial impact beyond that experienced by those receiving an abnormal cytology result alone (1). In addition to anxiety and concern there may be other psychological consequences of testing positive for HPV which relate to the sexually transmitted nature of the virus. Previous research suggests that women feel stigmatized, concerned about disclosing their result to others and concerned about their sexual relationships following a HPV positive result (2). The psychosexual impact of a HPV positive result has not been explored in the context of primary HPV testing but it is important that it is evaluated to determine the information needs and support required for women and to reduce the psychosexual burden of an HPV positive result, particularly as there will be far greater numbers of women receiving a HPV positive result than at present.This PhD will explore the psychosexual impact of HPV primary testing in routine cervical screening. The first study will involve using data from the Psychological Effects of Abnormal Pap Smears Questionnaire short form (PEAPS-Q-5), a measure of psychosexual functioning, collected as part of the Psychological Impact of Primary Screening for HPV study (PIPS), collected shortly after women receive their screening result. Differences in psychosexual functioning will be assessed between six groups of women with different combinations of HPV and cytology results: those who test negative for HPV, those who are HPV positive with normal cytology, those who are HPV positive with abnormal cytology, those who tested positive for HPV previously and are attending their 12-month follow up appointment who have persistent HPV and those who tested negative at the 12-month follow up appointment, and a control group who have been screened using cytology only. The second study will be a repeat of the first study but will assess psychosexual functioning 6 and 12 months post screening result. The results of the first two studies will inform further qualitative and quantitative research for the remainder of the PhD. 1. Maissi E, Marteau TM, Hankins M, Moss S, Legood R, Gray A. Psychological impact of human papillomavirus testing in women with borderline or mildly dyskaryotic cervical smear test results: cross sectional questionnaire study. BMJ. 2004;328(7451):1293.2. McCaffery K, Waller J, Nazroo J, Wardle J. Social and psychological impact of HPV testing in cervical screening: a qualitative study. Sexually Transmitted Infections. 2006;82(2):169-74.

NHS 宫颈筛查计划旨在通过检测和治疗宫颈异常来预防癌症。如果细胞学结果显示边缘或低度异常细胞变化，则目前使用细胞学检测人乳头瘤病毒 (HPV) 来检测宫颈异常。 HPV 是一种非常流行的性传播感染，几乎所有宫颈癌病例都可归因于 HPV 感染。研究表明，使用 HPV 检测作为宫颈的主要检测对于检测高度癌前病变更为敏感。 NHS 宫颈筛查计划目前在英格兰的 6 个地点使用 HPV 检测作为主要检测，计划到 2019 年在整个英格兰推广。之前评估 HPV 检测在宫颈筛查中的影响的研究表明，HPV 阳性结果所产生的不良社会心理影响超出了仅接受异常细胞学结果的人所经历的影响 (1)。除了焦虑和担忧之外，HPV 检测呈阳性还可能会产生其他心理后果，这些后果与病毒的性传播性质有关。先前的研究表明，在 HPV 呈阳性结果后，女性会感到受到侮辱，担心向他人透露自己的结果，并担心自己的性关系 (2)。尚未在初级 HPV 检测中探讨 HPV 阳性结果对性心理的影响，但重要的是对其进行评估以确定女性所需的信息需求和支持，并减少 HPV 阳性结果的性心理负担，特别是因为将会有比目前更多的女性获得 HPV 阳性结果。本博士将探讨 HPV 初步检测在常规宫颈筛查中对性心理的影响。第一项研究将涉及使用来自异常子宫颈抹片检查问卷简表（PEAPS-Q-5）的心理影响的数据，这是一种性心理功能的衡量标准，作为 HPV 初级筛查的心理影响研究（PIPS）的一部分收集。妇女收到筛查结果后不久。将评估六组具有不同 HPV 和细胞学结果组合的女性的性心理功能差异：HPV 检测阴性的女性、HPV 阳性但细胞学检查正常的女性、HPV 阳性但细胞学检查异常的女性、HPV 检测阳性的女性之前检测过 HPV 并正在参加 12 个月随访的患者，其中有持续 HPV 的患者和在 12 个月随访预约中检测呈阴性的患者，以及仅使用细胞学筛查的对照组。第二项研究将重复第一项研究，但将在筛查结果后 6 个月和 12 个月评估性心理功能。前两项研究的结果将为博士其余部分的进一步定性和定量研究提供信息。 1. Maissi E、Marteau TM、Hankins M、Moss S、Legood R、Gray A。人类乳头瘤病毒检测对宫颈涂片检查结果为临界或轻度核异常的女性的心理影响：横断面问卷研究。英国医学杂志。 2004；328(7451):1293.2。 McCaffery K、Waller J、Nazroo J、Wardle J。宫颈筛查中 HPV 检测的社会和心理影响：一项定性研究。性传播感染。 2006；82(2)：169-74。