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
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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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.