Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
JNCI Cancer Spectr. 2023 Jan 3;7(1). doi: 10.1093/jncics/pkac086.
In 2018, the US Preventive Services Task Force endorsed primary human papillomavirus testing (pHPV) for cervical cancer screening. We aimed to describe providers' beliefs about pHPV testing effectiveness and which screening approach they regularly recommend. We invited providers who performed 10 or more cervical cancer screens in 2019 in 3 healthcare systems that had not adopted pHPV testing: Kaiser Permanente Washington, Mass General Brigham, and Parkland Health; 53.7% (501/933) completed the survey between October and December 2020. Response distributions varied across modalities (P < .001), with cytology alone or cotesting being more often viewed as somewhat or very effective for 30- to 65-year-olds compared with pHPV (cytology alone 94.1%, cotesting 96.1%, pHPV 66.0%). In 21- to 29-year-olds, the pattern was similar (cytology alone 92.2%, 64.7% cotesting, 50.8% pHPV). Most providers were either incorrect or unsure of the guideline-recommended screening interval for pHPV. Educational efforts are needed about the relative effectiveness and recommended use of pHPV to promote guideline-concordant care.
2018 年，美国预防服务工作组（USPSTF）认可了人乳头瘤病毒（HPV）检测作为宫颈癌筛查的主要方法。我们旨在描述医疗服务提供者对 HPV 检测有效性的看法，以及他们通常推荐的哪种筛查方法。我们邀请了在三个医疗系统中进行了 10 次或更多宫颈癌筛查的医疗服务提供者参加这项研究，这三个系统尚未采用 HPV 检测：Kaiser Permanente Washington、Mass General Brigham 和 Parkland Health。在 2020 年 10 月至 12 月期间，有 53.7%（501/933）的参与者完成了调查。应答者的分布因检测方法而异（P<0.001），细胞学或联合检测被认为在 30 至 65 岁人群中对宫颈癌的筛查效果比 HPV 检测更为有效（细胞学单独检测 94.1%，联合检测 96.1%，HPV 检测 66.0%）。在 21 至 29 岁的人群中，情况类似（细胞学单独检测 92.2%，联合检测 64.7%，HPV 检测 50.8%）。大多数医疗服务提供者对 HPV 检测的推荐筛查间隔要么是不正确的，要么是不确定的。需要进行有关 HPV 检测的相对有效性和推荐使用的教育工作，以促进符合指南的护理。
