Communicating abnormal cervical cancer screening results – a focus group study with general practitioners in Norway

Background A gradual transition from cytology-based screening to Human Papillomavirus (HPV) testing within the cervical cancer screening program has resulted in new routines for follow-up, and new challenges for communication of abnormal test results. General practitioners (GPs) have an important role in the screening program, as they are the primary performers of the screening test, they communicate test results to patients and refer them to a specialist if necessary.Objective The study explores what consequences the introduction of HPV testing in the cervical cancer screening programme has for GPs’ professional practice and communication with patients.Design, setting and subjects Qualitative focus group study including 32 GPs in Central Norway who conduct screening tests within the cervical cancer screening programme.Results The overall concern of the GPs was to communicate abnormal test results in a way that ensured appropriate follow-up, without causing unnecessary worry. Staying updated on revised screening guidelines and maintaining their role as medical experts when communicating results to patients could be challenging. GPs shared the responsibility for follow-up after an abnormal result between themselves, the women, and the screening programme. Reciprocal familiarity between GP and patient guided decisions about what and how to communicate, and how to balance the shared responsibility. GPs used their professional judgement to assess patients’ informational needs and tailored information accordingly.Conclusion GPs manage the challenges of communicating abnormal screening results by sharing responsibility and using their professional judgement. Strengthening support and communication tools may enhance their role in the screening programme.