Taking Health into Your Own Hands: Evaluating Patient and Provider Perspectives of Human Papillomavirus Self-Sampling for Cervical Cancer Screenings and Opportunities for Education.

Abstract

Human papillomavirus (HPV) self-sampling was approved for use in clinical settings by the U.S. Food and Drug Administration (FDA) in May 2024 to identify high-risk HPV, responsible for most cervical cancer. This study explored patient and healthcare provider perspectives of HPV self-collection to assess perceived benefits, barriers, and facilitators to implementing this new screening service. Twenty patients at a cervical cancer screening event in the Bronx, NY, watched an instructional video and completed a survey regarding their willingness to use HPV self-sampling. Nine healthcare providers from the Montefiore Health System and affiliated Albert Einstein College of Medicine participated in semi-structured interviews to discuss their knowledge and beliefs toward adopting HPV self-sampling. Qualitative transcripts were coded in Dedoose and thematic analysis was used to identify emergent themes which were narratively described and supported by direct quotes. Patient participants were largely interested in HPV self-sampling and expressed willingness to use the modality at future screenings. Provider participants discussed anticipated benefits and concerns of HPV self-sampling, including expanding screening reach, prioritizing patients' needs, inadequate sampling, and losing opportunities for comprehensive care provided during pelvic exams. Patient and provider participants expressed enthusiasm about self-sampling improving access to cervical cancer screening, particularly for communities lacking access to current healthcare infrastructure. Provider participants critically questioned how HPV self-sampling could be introduced into their clinical practice. Both groups emphasized the need for further education to improve patient health literacy on self-sampling and for provider education through peer sharing, lectures, and information dissemination through heavily used mobile applications.