Primary HPV Testing for Cervical Cancer Screening Among Family Medicine Educators

Half of the women who develop cervical cancer in the US have never had a cervical cancer screen. Self-sampling is an equivalent technique to the invasive speculum exam. We aim to evaluate the current knowledge, attitudes, and behaviors toward self-sampled primary HPV testing in family medicine.

The annual cross-sectional survey of the Council of Academic Family Medicine's general membership included knowledge, attitudes, and beliefs about primary human papillomavirus (HPV) screening using self-sampling. The knowledge questions were based on current guidelines, as defined by the 2024 United States Preventive Services Task Force (USPSTF) 1. The attitude and belief questions were based on the Question-Behavior Theory 2. All surveys were emailed to the membership with up to five weekly reminders to complete.

We had a 62% survey response rate with 744 respondents. Regardless of demographic descriptors, all respondents significantly changed their intended behavior regarding offering self-sampling for cervical cancer screening (p < 0.001). Of those with a baseline attitude of not offering self-sampling, 88% changed their response to offer self-sampling at the end of the survey. Baseline knowledge of the advantages of primary HPV screening was lowest among underrepresented minority Hispanic respondents (52% correct, compared to 80% among Whites, p < 0.001). Women respondents were 2.96 times more likely to intend to offer self-sampling for cervical cancer screening than men (OR 2.96 (95% CI: 1.18, 7.44, p<0.05).

Based on the Question-Behavior Theory, over 90% of family medicine educators intend to offer women self-sampling for cervical cancer screening.