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Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana

Primary human papillomavirus (HPV) testing, in which a high-risk HPV test is administered without cytology, was first included in 2018 US cervical cancer screening guidelines. Subsequent guidelines endorsed primary HPV testing as the preferred method for cervical cancer screening following evidence...

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Autores principales: Rodriguez, Natalia M., Brennan, Luke P., Claure, Layla, Balian, Lara N., Kasting, Monica L., Champion, Victoria L., Forman, Michele R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719026/
https://www.ncbi.nlm.nih.gov/pubmed/36471770
http://dx.doi.org/10.1016/j.pmedr.2022.102070
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author Rodriguez, Natalia M.
Brennan, Luke P.
Claure, Layla
Balian, Lara N.
Kasting, Monica L.
Champion, Victoria L.
Forman, Michele R.
author_facet Rodriguez, Natalia M.
Brennan, Luke P.
Claure, Layla
Balian, Lara N.
Kasting, Monica L.
Champion, Victoria L.
Forman, Michele R.
author_sort Rodriguez, Natalia M.
collection PubMed
description Primary human papillomavirus (HPV) testing, in which a high-risk HPV test is administered without cytology, was first included in 2018 US cervical cancer screening guidelines. Subsequent guidelines endorsed primary HPV testing as the preferred method for cervical cancer screening following evidence of its clinical and economic benefits, although many sources still indicate it as an option along with cytology and HPV/Pap co-testing. Primary HPV testing could be key to improving the declining cervical cancer screening rates in the US; however its adoption has been slow as clinicians are hesitant to make the change. Indiana ranks in the top ten states for cervical cancer mortality, with marked race-ethnic disparities in cervical cancer screening and low HPV vaccination rates. To examine clinician practices, knowledge, and attitudes regarding primary HPV testing, in 2021 we conducted an online cross-sectional survey (n = 224) and in-depth interviews (n = 20) with Indiana clinicians practicing cervical cancer screening. Only 3 % reported using primary HPV testing for eligible patients, and only 50 % were willing to adopt it as the preferred cervical cancer screening method for the recommended patient group. In a multivariable logistic regression model, knowledge of the effectiveness (aOR 2.58 [1.41–4.72]) and perceived benefit (aOR 7.35 [3.65–14.81]) of primary HPV testing predicted willingness to adopt. In-depth interviews revealed knowledge gaps, uncertainty, and perceived limitations of this method as the reasons for limited uptake of primary HPV testing. Targeted messages about the benefits and effectiveness may enhance clinician knowledge, acceptance, and adoption.
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spelling pubmed-97190262022-12-04 Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana Rodriguez, Natalia M. Brennan, Luke P. Claure, Layla Balian, Lara N. Kasting, Monica L. Champion, Victoria L. Forman, Michele R. Prev Med Rep Regular Article Primary human papillomavirus (HPV) testing, in which a high-risk HPV test is administered without cytology, was first included in 2018 US cervical cancer screening guidelines. Subsequent guidelines endorsed primary HPV testing as the preferred method for cervical cancer screening following evidence of its clinical and economic benefits, although many sources still indicate it as an option along with cytology and HPV/Pap co-testing. Primary HPV testing could be key to improving the declining cervical cancer screening rates in the US; however its adoption has been slow as clinicians are hesitant to make the change. Indiana ranks in the top ten states for cervical cancer mortality, with marked race-ethnic disparities in cervical cancer screening and low HPV vaccination rates. To examine clinician practices, knowledge, and attitudes regarding primary HPV testing, in 2021 we conducted an online cross-sectional survey (n = 224) and in-depth interviews (n = 20) with Indiana clinicians practicing cervical cancer screening. Only 3 % reported using primary HPV testing for eligible patients, and only 50 % were willing to adopt it as the preferred cervical cancer screening method for the recommended patient group. In a multivariable logistic regression model, knowledge of the effectiveness (aOR 2.58 [1.41–4.72]) and perceived benefit (aOR 7.35 [3.65–14.81]) of primary HPV testing predicted willingness to adopt. In-depth interviews revealed knowledge gaps, uncertainty, and perceived limitations of this method as the reasons for limited uptake of primary HPV testing. Targeted messages about the benefits and effectiveness may enhance clinician knowledge, acceptance, and adoption. 2022-11-30 /pmc/articles/PMC9719026/ /pubmed/36471770 http://dx.doi.org/10.1016/j.pmedr.2022.102070 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Rodriguez, Natalia M.
Brennan, Luke P.
Claure, Layla
Balian, Lara N.
Kasting, Monica L.
Champion, Victoria L.
Forman, Michele R.
Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title_full Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title_fullStr Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title_full_unstemmed Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title_short Clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: A mixed-methods study in Indiana
title_sort clinician practices, knowledge, and attitudes regarding primary human papillomavirus testing for cervical cancer screening: a mixed-methods study in indiana
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719026/
https://www.ncbi.nlm.nih.gov/pubmed/36471770
http://dx.doi.org/10.1016/j.pmedr.2022.102070
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