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. 2025 Jan-Dec:21:17455057251362581.
doi: 10.1177/17455057251362581. Epub 2025 Sep 18.

Implementing self-collection for primary human papillomavirus testing: Perspectives on implications for federally qualified health center patient populations

Amanda Le  1 , Liisa S Smith  1 , Stephanie B Wheeler  2   3 , Kara Giannone  3   4 , MaryShell Zaffino  5 , Jennifer Elston Lafata  3   6 , Jennifer S Smith  3   7
Affiliations

Implementing self-collection for primary human papillomavirus testing: Perspectives on implications for federally qualified health center patient populations

Amanda Le et al. Womens Health (Lond). 2025 Jan-Dec.

Abstract

Background: Primary testing for high-risk human papillomavirus (HPV) via self-collection can increase cervical cancer screening rates. In the United States, federally qualified health center (FQHC) patients often have low incomes, lack health insurance, are medically underserved, and are screened less than the national average. Implementation of HPV self-collection can increase cervical cancer screenings among FQHCs.

Objectives: To assess the potential impact of implementing HPV self-collection with FQHC patients by considering perspectives of frontline clinical and administrative staff and leadership to identify patient-focused implementation considerations.

Design: This qualitative study utilized focus groups and key informant interviews, and transcripts were analyzed using a coding-based thematic analysis. Emergent themes regarding self-collection implementation perspectives were mapped onto Consolidated Framework for Implementation Research constructs to identify potential facilitators and barriers to implementation for FQHC patient populations.

Methods: Participants from six FQHCs in North Carolina were identified. Forty-five clinical and administrative staff participated in focus groups. One chief executive officer, senior level administrator, chief medical officer, and clinical data manager from each FQHC (N = 24) were interviewed one-on-one. Coding-based thematic analysis was applied to focus group and interview transcripts to uncover emerging themes.

Results: Interviewees indicated that HPV self-collection can be advantageous to patients who do not routinely visit the clinic due to socioeconomic and cultural barriers. Programs must consider these barriers and patient literacy to ensure proper self-collection utilization. For example, FQHC patients may benefit from illustrated instructions for proper self-collection procedures.

Conclusion: Tailoring an HPV self-collection implementation to FQHC patient populations may be an important strategy for increasing screening.

Keywords: cervical cancer; federally qualified health centers; human papillomavirus; self-collection.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Jennifer S. Smith has received research grants and consultancies from Hologic and Becton Dickenson over the past 5 years. Stephanie B. Wheeler receives unrelated grant funding from the Pfizer Foundation and AstraZeneca. Jennifer E. Lafata receives unrelated grant funding from Genentech. The remaining authors have no conflicts of interest to declare.

References

    1. U.S. Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2018; 320(7): 674–686. - PubMed
    1. Fontham ETH, Wolf AMD, Church TR, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin 2020; 70(5): 321–346. - PubMed
    1. Benard VB, Jackson JE, Greek A, et al. A population study of screening history and diagnostic outcomes of women with invasive cervical cancer. Cancer Med 2021; 10(12): 4127–4137. - PMC - PubMed
    1. Landy R, Mathews C, Robertson M, et al. A state-wide population-based evaluation of cervical cancers arising during opportunistic screening in the United States. Gynecol Oncol 2020; 159(2): 344–353. - PMC - PubMed
    1. Suk R, Hong Y, Rajan SS, et al. Assessment of US Preventive Services Task Force Guideline–Concordant Cervical Cancer Screening Rates and reasons for underscreening by age, race and ethnicity, sexual orientation, rurality, and insurance, 2005 to 2019. JAMA Netw Open 2022; 5(1): e2143582. - PMC - PubMed