Awareness and support of clinician- and patient-collected human papillomavirus testing for cervical cancer screening among primary care clinicians
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Authors
MacLaughlin, Kathy L.
Jacobson, Robert M.
Sauver, Jennifer L. St.
Jenkins, Gregory D.
Fan, Chun
Rutten, Lila J. Finney
Issue Date
2022-01
Type
Article
Language
en_US
Keywords
Cervical Cancer Screening , Primary HPV Test
Alternative Title
Abstract
Background: Cervical cancer screening has shifted toward human papillomavirus (HPV)-based testing, but uptake of primary HPV screening in the United States is unknown and previous studies highlight delays in clinician adoption of guideline updates.
Methods: We conducted a cross-sectional electronic survey of primary care clinicians (n = 252; response rate = 30.9%) assessing awareness and support of primary HPV screening. We assessed factors for association with past use of HPV testing and support of clinician- and patient-collected HPV testing individually using Fisher's exact test and jointly using Firth's logistic regression.
Results: Most clinicians (79%) were familiar with one or more primary HPV screening guidelines. Support for clinician-collected (89%) and patient-collected (82%) HPV testing was high, but only 34.5% reported prior use. Guideline familiarity was positively associated with HPV testing in practice (p = 0.0001). Support of clinician-collected testing was positively associated with more years in practice (p = 0.03), internal (vs. family) medicine specialty (p = 0.03), and guideline familiarity (p ≤ 0.0001). Male clinicians more frequently supported patient collection for patients overdue for screening (p = 0.013). Physicians more frequently than advanced practice providers (APPs) supported patient collection for screening-adherent women (p = 0.021). Multivariable analysis showed those unfamiliar with guidelines were less likely to have used HPV testing [odds ratio, OR: 0.10 (0.03–0.32)] or to support clinician-collected HPV testing [OR: 0.16 (0.07–0.37)]. APPs were less likely than physicians to support patient-collected HPV testing among screening-adherent women [OR: 0.42 (0.20–0.87)].
Conclusions: We observed high levels of guideline awareness and clinician support for primary HPV testing, despite relatively low use. This merits further exploration to inform future interventions to increase uptake.
Description
Citation
MacLaughlin, K. L., Jacobson, R. M., St Sauver, J. L., Jenkins, G. D., Fan, C., & Finney Rutten, L. J. (2022). Awareness and Support of Clinician- and Patient-Collected Human Papillomavirus Testing for Cervical Cancer Screening Among Primary Care Clinicians. Women's health reports (New Rochelle, N.Y.), 3(1), 10–19. https://doi.org/10.1089/whr.2021.0074
Publisher
Women's health reports (New Rochelle, N.Y.)