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Comparing strategies for implementing primary human papillomavirus (HPV) testing for routine cervical cancer screening
Investigator (PI): Chao, Chun
Performing Organization (PO): (Current): Kaiser Permanente Research, Department of Research & Evaluation / (626) 564-3455
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2019
Final Year: 2023
Record Source/Award ID: PCORI/CDR-2018C1-10987
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Cervical cancer screening is an important component of women's health care. Most adult women are familiar with the conventional screening modality, the Pap test, which has successfully reduced the burden of cervical cancer in industrialized countries. However, the Pap test has limited accuracy and can miss a progressing disease. Advancement in knowledge and technology has led to changes in national recommendations to focus on the testing of high-risk human papillomavirus (HPV) infection, the cause of cervical cancer. Screening with primary HPV testing detects more diseases compared with the Pap test alone or co-testing and requires fewer tests. However, despite the advantages of primary HPV screening over conventional approaches, the switch to primary HPV screening is limited in the United States. The scientific literature reports barriers at both the provider and woman levels, which include lack of knowledge, resistance, and attachment to the Pap test. We currently have insufficient guidance on how to select and deploy implementation strategies most likely to facilitate the use of the newly recommended cancer screening modality. This project seeks to generate evidence regarding effective strategies to achieve successful implementation of primary HPV testing for routine cervical cancer screening in a large community-based health care delivery system. A successful implementation will be defined by uptake of primary HPV screening, adequate knowledge of the HPV test for both patients and providers, and patient/provider satisfaction during the transition. This project is important to most adult women, as a timely adoption of the best evidence-based cancer screening approach means better patient outcomes--more cancers prevented, and more cancers treated early. Further, the proposed project will inform not only about cervical cancer screening, but also other clinical conditions when a physician practice change is recommended by professional societies and/or national guideline body, such as replacing an outdated or low-value breast cancer screening test. By engaging patients, health care providers, and other professional stakeholders in this project, we ensure that successful project outcomes are those most important for women and their doctors. Further, the stakeholder partners will help ensure the generalizability of our findings to other health care systems, design strategies that maximize completeness in data collection, and lead the dissemination effort for wide application of the knowledge to be gained in this project.
MeSH Terms:
  • Access to Health Care
  • Cervical Neoplasms /*diagnosis
  • /*virology
  • Community Health Services /organization & administration
  • Early Detection of Cancer /methods
  • Evidence-Based Medicine /organization & administration
  • Female
  • Humans
  • Mass Screening /methods
  • Patient Participation
  • Patient Satisfaction
  • Program Development
  • United States
Country: United States
State: California
Zip Code: 91101
UI: 20194148
Project Status: Ongoing