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Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide

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Procedure to collect samples for HPV testing – Counselling of a woman undergoing HPV testing


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Counselling for cervical cancer screening and management of screen-positive women:
Counselling before screening is crucial, because it helps women make an informed decision. Women attending a screening clinic should be educated about the importance of cervical cancer screening, the test procedures, possible test outcomes, and the availability of simple and safe treatment options for cervical abnormalities. It is important to explain that a negative HPV test result implies no risk of cervical cancer in the next 5–10 years but that the test should be repeated at regular intervals.

Because most of the women attending screening clinics are without symptoms, it is important that they are counselled appropriately about the implications of the test results. Lack of adequate information may lead to a negative psychological reaction to a positive HPV test result and subsequent non-compliance with diagnosis and treatment. Effective counselling facilitates an improvement in the compliance of women not only with screening but also with any subsequent follow-up visits. Furthermore, face-to-face interaction helps women overcome the fear and embarrassment of a gynaecological check-up.

Myths and misconceptions related to cervical cancer, screening, and treatment:

There are many myths and misconceptions about the causes, prevention, and treatment of cervical cancer. These myths and misconceptions can prevent women from seeking cervical cancer screening and management services. Understanding the most common myths and misconceptions will help the counsellor or health-care provider to effectively address these by providing accurate information to women and their family members during counselling sessions.
Below is an animation presenting a collection of myths and misconceptions about cervical cancer and the corresponding facts that the counsellor or health-care provider can use to address them during a counselling session. Click here to download the myths and misconceptions about cervical cancer.

Steps of pre-screening counselling:
Begin a counselling session by greeting the woman (and her husband or partner, if present) respectfully and introducing yourself. Help the woman feel relaxed by ensuring adequate privacy and starting with general pleasantries (e.g. “How are you doing today?”).

Provide information about the following:
  • Location of the cervix in the woman’s body
  • Cause of and risk factors for cervical cancer
  • Importance of screening for cervical cancer
  • The HPV test and how it is performed
  • HPV test results and their implications
  • Further tests or procedures that the woman will have to undergo if the test result is positive
  • Available simple and safe treatment methods, if required
  • Importance of follow-up visits even after treatment
  • If the test result is negative, it is important that the test is repeated at regular intervals as advised, to prevent cervical cancer.
Avoid using scientific terms as much as possible. Encourage the woman to ask questions, and respond to her concerns (if any) in a reassuring manner. Where these are available, use models or visual aids (in the form of posters, flipbooks, and leaflets) as a means of communication. Reassure the woman that her privacy will be maintained during the examination and the outcomes of the screening test will be kept confidential. Obtain the woman’s consent for screening, if this is indicated by the programme guidelines. End the counselling session by thanking the woman (and her husband or partner, if present).

The next section describes the steps of history taking before screening.

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