Clinician acceptability of self-collected human papillomavirus swabs as a primary cervical cancer screening method

[摘要] Objective To determine knowledge and acceptability of and opinions abouthuman papillomavirus (HPV) self-screening as an alternative to Papanicolaoutesting among Canadian primary care providers (PCPs: family physicians andnurse practitioners) and obstetrician-gynecologists (OB-GYNs).Design Descriptive, cross-sectional, anonymous, online pilot survey.Setting Two academic teaching hospitals in downtown Toronto, Ont.Participants Staff physicians and nurse practitioners in the Departmentof Family and Community Medicine and the Department of Obstetrics andGynecology at Women’s College Hospital and St Michael’s Hospital.Main outcome measures Recommended patient groups for, potentialadvantages and disadvantages of, and likelihood of recommending HPV selfsampling for cervical cancer screening.Results The overall response rate was 30.9%. More than three-quarters ofsurvey respondents were female PCPs. Slightly more than half of clinicianshad poor knowledge of HPV self-sampling. However, more than three-quarterswould recommend it if there were adequate collection of cervical samples,high patient acceptability, and high sensitivity (almost 100% of respondents),followed by high specificity and cost-effectiveness (more than 80% ofrespondents). Primary care practitioners were more likely than OB-GYNs toagree that HPV self-sampling made screening easier and less embarrassingfor patients. Although not statistically significant, OB-GYNs tended to be moreconcerned than PCPs were about patients failing to follow up on abnormal HPVresults and missed opportunities to address other health issues.Conclusion Although knowledge of HPV self-sampling for cervical screeningwas poor, it was generally acceptable to clinicians if certain screening testconditions were met. However, the potential for missed opportunities tovisualize pathology and address other health concerns were raised. These andother clinical practice and health systems issues must be addressed beforebroad implementation of HPV self-sampling in Canada.

[学科分类] 卫生学