Using behavioural science to maximise the impact of cervical cancer control policies

Funded as part of a Cancer Research UK career development fellowship, this project aims to better understand non-participation in cervical screening and HPV vaccination. With highly effective preventive technologies for cervical cancer, reducing incidence and mortality now depends largely on individual behaviour. This work aims to develop interventions to increase informed participation in screening and vaccination.

Investigating cervical screening

Psychological impact of primary HPV screening (PIPS) study

The study was commissioned by Public Health England to evaluate the psychological impact of taking part in HPV testing in the NHS Cervical Screening Programme. With the roll-out of HPV primary screening across England in 2019, it is essential to understand the potential psychological impact of an HPV positive result on the women taking part. This work aims to identify ways of optimising communication approaches to minimise anxiety. A cross-sectional survey was carried out in five of the NHS sites where HPV primary screening has been piloted. Women receiving their screening results were invited to complete a questionnaire, with follow-up surveys 6 and 12 months later. Results of the follow-up surveys are currently being analysed .

Psychological impact of primary HPV screening (PIPS study)

Maximising acceptability of risk stratification in the NHS breast screening programme

Women aged 50-70 years in England are offered 3-yearly breast screening but there is increasing interest in stratifying screening to women’s individual breast cancer risk. This would optimise the harm/benefit ratio and would decrease the risk of overdiagnosis in low-risk women. Alongside work to develop risk assessment algorithms and appropriate management of women in different risk groups, it is essential that we understand how to maximise acceptability and uptake in women in the target age-group. The project will use a series of three studies to 1) explore women’s attitudes to risk-stratified breast screening, 2) quantify the importance of a range of attributes for the acceptability of risk-stratified screening, and 3) compare the acceptability of different approaches to risk-stratified screening.

Psychological Impact of the Galleri Test

The NHS-Galleri trial will see whether the Galleri test, a multi-cancer blood test developed by GRAIL, can find cancer earlier when combined with standard cancer testing, compared with usual NHS care. This project is nested within the trial and will explore psychological outcomes among participants who have a cancer signal detected in their blood. The project will include two studies. Study 1 will be a longitudinal evaluation of participants who have a cancer signal detected. Data will be collected at three time points over a 12-month period. Study 2 will be a qualitative investigation of the experience of participants with a positive cancer signal result (including those who go on to receive a cancer diagnosis and those with false positive results). This work is funded by GRAIL Bio Inc.

NHS-Galleri Trial

Acceptability of MCED tests within population-based screening programmes

Acceptability is essential for the successful implementation of new screening tests. Using both qualitative and quantitative methods, this project will explore anticipated barriers and facilitators to participating in screening using the Galleri multi-cancer blood test. A key focus of the project will be to identify and understand potential inequalities in uptake. This work is funded by GRAIL Bio Inc.

Acceptability and communication of the use of artificial intelligence in the NHS Breast Screening Programme

The use of Artificial Intelligence (AI) in healthcare is a rapidly expanding field, with great potential for supporting healthcare professionals and organisations in faster and more efficient delivery of services. One area of healthcare in which the use of AI is currently being tested is in breast cancer screening. To ensure that the adoption of AI within the NHS Breast Screening Programme does not have a negative impact on participation in the screening, it is essential that the views and concerns of the people invited to screening are considered. This project is investigating public perceptions surrounding the acceptability of using AI in breast screening, paying particular attention to areas where social inequalities may be exacerbated.