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HPV self-collection: what are we waiting for? Exploration of attitudes from frontline healthcare providers
  1. Jacqueline A Bohn1,
  2. Katherine C Fitch1,
  3. Jessica J Currier2 and
  4. Amanda Bruegl1
  1. 1Department of Obstetrics & Gynecology, Oregon Health & Sciences University, Portland, Oregon, USA
  2. 2Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
  1. Correspondence to Dr Jacqueline A Bohn, OB/GYN, Oregon Health & Science University, Portland, OR 97239, USA; jacbohn{at}gmail.com

Abstract

Objective Polymerase chain reaction based human papilloma virus (HPV) self-collection for cervical cancer screening is well established. It is utilized worldwide, accepted by patients, is cost-effective, has comparable sensitivity to provider-collected samples, and increases screening rates, however clinical practice in the United States has not shifted to include HPV self-collection. This study sought to examine provider knowledge and attitudes to better understand why HPV self-collection is not being utilized.

Methods An observational, qualitative study was conducted. Data were collected with semi-structured focus groups and individual interviews with Oregon healthcare providers. Focus groups and interviews were continued until data saturation was achieved. A grounded theory method was used for analysis, a cyclical process of coding data, memo-writing, and theoretical sampling to the point of saturation.

Results Eighteen healthcare providers participated in the focus group and interviews. They represented 14 of 36 counties across Oregon and 50% were physicians, 33% were nurse practitioners, and 94% worked within family medicine. All providers performed cervical cancer screening according to current American Society for Colposcopy and Cervical Pathology guidelines. Five overarching themes emerged: provider concerns, clinical and provider barriers, patient perspective and barriers, process-based themes, and barriers to cervical cancer screening. Nearly all providers stated they will offer HPV self-collection to most of their patients once available.

Conclusion While providers identified concerns and barriers for initiating HPV self-collection, there was a strong desire to implement HPV self-collection and acceptance within patient populations was assumed. Providers indicated the need for HPV self-collection to be incorporated into national screening guidelines along with best practices on how to successfully implement this modality to further increase cervical cancer screening rates.

  • Cervical Cancer
  • Gynecology

Data availability statement

Data are available upon reasonable request. A complete set of the qualitative data is available upon reasonable request.

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Data availability statement

Data are available upon reasonable request. A complete set of the qualitative data is available upon reasonable request.

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Footnotes

  • Contributors JAB: conceptualization, methodology, writing-original draft preparation. KF: formal analysis, writing-original draft preparation. JJC: conceptualization, methodology, formal analysis, writing-review and editing. AB: guarantor, conceptualization, methodology, formal analysis, writing-review and editing, supervision.

  • Funding AB is funded through an NCI K08 award. Support for this research was provided in part by the Robert Wood Johnson Foundation.

  • Disclaimer The views expressed here do not necessarily reflect the views of the Foundation. The remaining authors have no funding or conflicts of interest to disclose.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.