Uptake and feasibility of HPV self-sampling among patients of a Canadian family medicine clinic.

OBJECTIVE

To determine the uptake and feasibility of human papillomavirus self-sampling (HPV SS) offered to patients in a family medicine clinic.

DESIGN

Implementation study.

SETTING

Community family medicine clinic in Edmonton, Alta, with a cervical cancer screening rate of 80%.

PARTICIPANTS

Patients 25 to 69 years old with a cervix who had not received a Papanicolaou (Pap) test in 2.5 years or more. Exclusion criteria included being pregnant; experiencing colposcopy care or having been discharged from care within 11 months; having history of invasive cancer; experiencing abnormal vaginal bleeding or current menstruation; identifying as transgender; and having abnormal results on the last Pap test.

INTERVENTIONS: Eligible patients were opportunistically offered HPV SS in the clinic (September 2024 to November 2024) as the first phase of the Alberta Cervical Cancer Screening HPV SS pilot program.

MAIN OUTCOME MEASURES: The primary outcome was the proportion of patients who completed HPV SS. Secondary outcomes were factors associated with completing HPV SS, HPV SS results, patient preferences, physician perspectives, and environmental impact.

RESULTS

Overall, 226 patients were offered HPV SS. Characteristics of patients included the following: the median age was 43 years (interquartile range [IQR]=32 to 56); 89% lived in urban areas; 14% were immigrants; 4% were Indigenous; 58% were panelled (ie, attached to a family physician); and the median number of months since a last Pap test was 37 (IQR=32 to 45). Overall, 81% completed HPV SS: 165 had negative results, 17 were positive, and 2 were indeterminate, resulting in 7 Pap tests and 10 direct colposcopy referrals. Among patients who completed HPV SS, 98% preferred to have HPV SS as an option for future screening. Family physicians supported its use and HPV SS has the potential to decrease carbon impact by up to 20%.

CONCLUSION

The study suggests that HPV SS may be the preferred cervical cancer screening approach for patients attending a family medicine clinic. Screening programs should consider improving access to HPV SS for this population.