Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand

Sarah Ingamells; Rebecca Bell; Janine Nip; Carrie Innes; Sarah Te Whaiti; Alex Tino; Lynn McBain; John McMenamin; Ben Hudson; Melanie Gibson; Bev Lawton; Peter Sykes

doi:10.26635/6965.6308

Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand

N Z Med J. 2024 Feb 23;137(1590):57-76. doi: 10.26635/6965.6308.

Authors

Sarah Ingamells¹, Rebecca Bell², Janine Nip³, Carrie Innes³, Sarah Te Whaiti¹, Alex Tino⁴, Lynn McBain⁵, John McMenamin⁶, Ben Hudson⁷, Melanie Gibson⁸, Bev Lawton⁹, Peter Sykes¹⁰

Affiliations

¹ Senior obstetrics and gynaecology registrar, Department of Obstetrics and Gynaecology, University of Otago Christchurch, Christchurch, New Zealand.
² Senior research assistant, University of Otago Christchurch, Christchurch, New Zealand.
³ Research fellow, University of Otago Christchurch, Christchurch, New Zealand.
⁴ PhD student, University of Otago Christchurch, Christchurch, New Zealand.
⁵ Associate Professor, Department of Primary Health Care and General Practice, University of Otago Wellington, Wellington, New Zealand.
⁶ Clinical Health Director, Health and Research Collaborative, Whanganui, New Zealand.
⁷ Senior Lecturer, Department of Primary Care and Clinical Simulation, University of Otago Christchurch, Christchurch, New Zealand.
⁸ Senior research fellow, Te Tātai Hauora o Hine-National Centre for Women's Health Research Aotearoa, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
⁹ Professor, Te Tātai Hauora o Hine-National Centre for Women's Health Research Aotearoa, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
¹⁰ Associate Professor, Department of Obstetrics and Gynaecology, University of Otago Christchurch, Christchurch, New Zealand.

PMID: 38386856
DOI: 10.26635/6965.6308

Abstract

Aims: Cervical cancer remains a burden within Aotearoa New Zealand, with 2022 screening rates sitting 12.7% below target. The National Cervical Screening Programme has changed to primary human papillomavirus (HPV) testing for all screen-eligible people, with the aim for home self-testing. Little is known about the readiness of primary care for the change to self-testing and its associated challenges. A pilot HPV cervical cancer screening programme is being conducted in 17 practice centres. The aim of this study is to explore smear-taker knowledge at these centres about the use of primary HPV testing for cervical cancer screening.

Methods: This is an ethically approved questionnaire study, with data from a structured web-based questionnaire sent to all smear-takers at the pilot centres.

Results: We achieved a total completion rate of 57.8%. The average score for "Knowledge of HPV" was 56.5% (range=20-100%). The challenges to patient home HPV self-testing were felt to be overall "not at all" to "mildly challenging". Up to 73.3% of participants identified ongoing needs for further education.

Conclusions: The findings indicate knowledge deficits regarding HPV testing for cervical cancer screening and a desire for the provision of further education. Overall, respondents felt that no major barriers to implementing HPV self-testing would occur.

MeSH terms

Early Detection of Cancer
Female
Humans
Mass Screening
New Zealand
Papillomaviridae
Papillomavirus Infections* / diagnosis
Primary Health Care
Surveys and Questionnaires
Uterine Cervical Neoplasms* / diagnosis
Uterine Cervical Neoplasms* / prevention & control
Vaginal Smears