BRIEF REPORT
Alisa P. Young, MD; Rosa Reyes, DO, MS; Chidera Mgbudem, MD; Dongru Chen, MS; Ananda Sen, PhD; Diane M. Harper, MD, MPH, MS
Corresponding Author: Diane M. Harper, MD, MPH, MS; Department of Family Medicine, Department of Obstetrics and Gynecology, University of Michigan.
Email: harperdi@med.umich.edu
DOI: 10.3122/jabfm.2025.250328R1
Keywords: Cancer Screening, Cervical Cancer, Culture, Family Medicine, Human Papillomavirus Viruses, Primary Health Care, Residency, Surveys and Questionnaires
Dates: Submitted: 08-19-2025; Revised: 11-10-2025; Accepted: 12-08-2025
Status: In Press.
BACKGROUND: Half of the women who develop cervical cancer in the US have never had a cervical cancer screen. Self-sampling is an equivalent technique to the invasive speculum exam. We aim to evaluate the current knowledge, attitudes, and behaviors toward self-sampled primary HPV testing in family medicine.
METHODS: The annual cross-sectional survey of the Council of Academic Family Medicine's general membership included knowledge, attitudes, and beliefs about primary HPV screening using self-sampling. The knowledge questions were based on current guidelines, as defined by the 2024 USPSTF. 1.) The attitude and belief questions were based on the Question-Behavior Theory. 2.) All surveys were emailed to the membership with up to five weekly reminders to complete.
RESULTS: We had a 62% survey response rate with 744 respondents. Regardless of demographic descriptors, all respondents significantly changed their intended behavior regarding offering self-sampling for cervical cancer screening (p < 0.001). Of those with a baseline attitude of not offering self-sampling, 88% changed their response to offer self-sampling at the end of the survey. Baseline knowledge of the advantages of primary HPV screening was lowest among underrepresented minority Hispanic respondents (52% correct, compared to 80% among Whites, p < 0.001). Female respondents were 2.96 times more likely to intend to offer self-sampling for cervical cancer screening than males (OR 2.96 (95% CI: 1.18, 7.44, p<0.05).
CONCLUSIONS: Based on the Question-Behavior Theory, over 90% of family medicine educators intend to offer women self-sampling for cervical cancer screening.