Are Health Care Professionals Prepared to Implement Human Papillomavirus Testing? A Review of Psychosocial Determinants of Human Papillomavirus Test Acceptability in Primary Cervical Cancer Screening

Tatar, Ovidiu; Wade, Kristina; McBride, Emily; Thompson, Erika L.; Head, Katharine J.; Perez, Samara; Shapiro, Gilla K.; Waller, Jo; Zimet, Gregory D.; Rosberger, Zeev

doi:10.1089/jwh.2019.7678

Cited by 11 publications

(13 citation statements)

References 51 publications

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“…43,44 Providers must also manage the multiplicity of clinical guidelines for cervical cancer screening from various professional organizations 45 and stay abreast of changes in these guidelines. 46 Thus, additional research is needed in the area of provider recommendation for cervical cancer screening and shared decision-making between patients and providers, especially in light of recent guidelines changes. Overall, demographic characteristics were not associated with willingness for an HPV test, with the exception of educational attainment.…”

Section: Discussionmentioning

confidence: 99%

Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing

Thompson

Galvin

Daley

et al. 2020

Preventive Medicine

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Cervical cancer screening guidelines in the United States were revised in 2018 to include the option of primary human papillomavirus (HPV) testing. The transition to this screening method may face difficulties as Pap testing has been the primary screening modality in the United States. The objective of this study is to assess information, motivation, and behavioral skills associated with willingness to receive an HPV test instead of a Pap test among women. The sample included U.S. 812 women, ages 30 to 65 years. Participants completed an online survey in 2018. The Information, Motivation, and Behavioral Skills (IMB) model was used to measure predictors of willingness for HPV testing. The outcome variables were willingness to receive the HPV test instead of the Pap test, with and without time interval details. Logistic regression modeling was used with SAS 9.4. Over half of the sample (55%) were willing to receive the HPV test. For the information domain, HPV knowledge was significantly associated with willingness for HPV testing (OR=1.08, 95%CI 1.04-1.13). Significant motivating factors included: positive attitudes, social norms, perceived benefits, worry about cervical cancer, and worry about abnormal HPV tests. For behavioral skills, women were significantly more willing to get the HPV test if a provider recommended it (OR=2.43, 95%CI 1.53-3.87) and currently up-to-date on cervical cancer screening guidelines (OR=1.52, 95%CI 1.52-2.26). Addressing barriers and facilitators to willingness to transition to primary HPV testing over Pap testing is needed as the United States has updated guidelines for cervical cancer screening.

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Section: Discussionmentioning

confidence: 99%

Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing

Thompson

Galvin

Daley

et al. 2020

Preventive Medicine

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“…Sample-takers may also be well-placed to provide information at cervical screening appointments. However, healthcare professionals can have limitations to their own knowledge of HPV and may require different forms of training ( McSherry et al, 2018 , Mcsherry et al, 2012 , Sherman et al, 2019 , Tatar et al, 2019 ). Efforts have been made to develop healthcare professional training materials in England, but interventions may be required to facilitate learning outcomes and engagement ( Public Health England, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Testing positive for Human Papillomavirus (HPV) at primary HPV cervical screening: A qualitative exploration of women’s information needs and preferences for communication of results

Symmons

Waller

McBride

2021

Preventive Medicine Reports

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Human Papillomavirus (HPV) primary cervical screening was implemented across England during 2019, where cervical cell samples are first tested for HPV and cytology is used to triage HPV-positive results. Around 8.5% of women who attend test HPV-positive with normal cytology (HPV+/normal). We aimed to explore women’s information needs and suggestions for improvements to result communication following an HPV+/normal result, among those with higher and lower levels of education. In‐depth interviews were conducted with 30 women aged 24–63 who had tested HPV+/normal at routine screening. Secondary qualitative data, not previously reported, were analysed using Framework Analysis to compare themes between those with education lower-than-degree-level vs. degree-level-or-higher (n = 15 in each group). Regardless of education level, women had unanswered questions about their result meaning and the HPV primary screening protocol. Expectations of cervical screening did not always match the service provided, especially regarding content of letters and mode of result delivery. Women with lower education were less clear about the meaning of normal cytology and its link to HPV; and had difficulty sourcing information after their result. Pragmatic suggestions were made for preferences in content, wording, format, and delivery of information in patient communications. Overall, our findings point to areas which can be used by policymakers and healthcare professionals to inform content and communication of results, as HPV primary screening continues to be implemented and refined worldwide. Future research should use these suggestions to develop patient materials and then test them to assess content engagement and information recall.

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“… 13–15 Clinician perspectives related to use of primary HPV tests for screening published before the 2018 USPSTF update show knowledge gaps regarding efficacy of HPV testing and low levels of compliance with screening guidelines in terms of age of HPV test initiation and frequency. 16 …”

Section: Introductionmentioning

confidence: 99%

Awareness and Support of Clinician- and Patient-Collected Human Papillomavirus Testing for Cervical Cancer Screening Among Primary Care Clinicians

MacLaughlin

Jacobson²,

Sauver³

et al. 2022

Women's Health Reports

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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.

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Are Health Care Professionals Prepared to Implement Human Papillomavirus Testing? A Review of Psychosocial Determinants of Human Papillomavirus Test Acceptability in Primary Cervical Cancer Screening

Cited by 11 publications

References 51 publications

Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing

Recent changes in cervical cancer screening guidelines: U.S. women's willingness for HPV testing instead of Pap testing

Testing positive for Human Papillomavirus (HPV) at primary HPV cervical screening: A qualitative exploration of women’s information needs and preferences for communication of results

Awareness and Support of Clinician- and Patient-Collected Human Papillomavirus Testing for Cervical Cancer Screening Among Primary Care Clinicians

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