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