Gezels Eva, Willems Sara, Vanthomme Katrien, Keersse Lien, Van Roy Kaatje
Ghent University, Ghent, Belgium.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251320178. doi: 10.1177/21501319251320178. Epub 2025 Mar 25.
Screening coverage for cervical cancer remains suboptimal in Flanders, Belgium. The upcoming transition to primary HPV screening in January 2025 presents an opportunity to offer self-sampling kits (SSKs) as an alternative to conventional Pap smears, with the potential to increase participation rates. General practitioners (GPs) can play a crucial role in reaching under-screened populations. Hereto it is essential to understand the needs and preferences of GPs regarding the integration of SSKs into their routine practice.
Semi-structured interviews were conducted with GPs participating in an implementation study on the added value of SSKs for long-term non-screened women, focusing on their experiences, challenges, and suggestions regarding the provision of SSKs to these patients.
The interviewed GPs recognized the potential of SSKs to increase participation, particularly due to their less invasive nature, which makes them more acceptable to underscreened women. Time constraints, technical software challenges, limited knowledge and doubt about SSK accuracy were identified as key barriers to implement SSKs in routine practice. GPs emphasized the need for adaptability in the distribution methods of SSKs, with many preferring a combination of mailing the SSKs and providing them in person. Personalized communication and tailored explanations were considered as crucial to ensure patient acceptance and the correct use of the tests.
This study shows that while GPs recognize the potential of SSKs to enhance cervical cancer screening, several challenges need to be addressed for their effective integration into primary care. A successful approach should incorporate streamlined support systems, tailored approaches to implement reminders for GPs and improved education for GPs. Future research should consider quantitative data on the effectiveness and cost-efficiency of SSKs in the specific context of Flanders and the perspectives of a broader range of stakeholders, including patients, practice nurses, gynecologists and policymakers, to develop more comprehensive strategies for the successful implementation of SSKs.
在比利时弗拉芒地区，宫颈癌筛查覆盖率仍未达到最佳水平。2025年1月即将向原发性人乳头瘤病毒（HPV）筛查过渡，这为提供自检试剂盒（SSK）作为传统巴氏涂片检查的替代方案提供了契机，有望提高参与率。全科医生（GP）在覆盖筛查不足人群方面可发挥关键作用。为此，了解全科医生在将自检试剂盒纳入其日常工作方面的需求和偏好至关重要。
对参与一项关于自检试剂盒对长期未接受筛查女性附加价值的实施研究的全科医生进行了半结构化访谈，重点关注他们在向这些患者提供自检试剂盒方面的经验、挑战和建议。
接受访谈的全科医生认识到自检试剂盒在提高参与率方面的潜力，特别是因为其侵入性较小，这使得筛查不足的女性更容易接受。时间限制、技术软件挑战、对自检试剂盒准确性的知识有限和怀疑被确定为在日常工作中实施自检试剂盒的关键障碍。全科医生强调自检试剂盒分发方式需要具有适应性，许多人更喜欢将自检试剂盒邮寄和亲自提供相结合的方式。个性化沟通和针对性解释被认为对于确保患者接受和正确使用检测至关重要。
本研究表明，虽然全科医生认识到自检试剂盒在加强宫颈癌筛查方面的潜力，但要将其有效纳入初级保健仍需解决一些挑战。成功的方法应包括简化的支持系统、针对全科医生实施提醒的定制方法以及对全科医生的强化教育。未来的研究应考虑在弗拉芒地区的特定背景下关于自检试剂盒有效性和成本效益的定量数据，以及包括患者、执业护士、妇科医生和政策制定者在内的更广泛利益相关者的观点，以制定更全面的策略来成功实施自检试剂盒。
