Gaps in health professionals' knowledge about HPV and cervical screening
The first New Zealand study of health professionals' knowledge and understanding about the human papillomavirus (HPV) has identified significant gaps, particularly about the role of HPV testing in the New Zealand National Cervical Screening Programme.
The study, which was recently published in the journal PLOS ONE, surveyed 230 practice nurses, smear takers and other clinical and laboratory staff via a cross-sectional survey, between April 2016 and July 2017.
Dr. Collette Bromhead, from Massey University's School of Health Sciences, led the research and says while the mean scores on the general HPV knowledge questions were high (13.2 out of 15), only 25.2 per cent of respondents scored 100 per cent.
"Only 63.7 per cent of respondents agreed or strongly agreed they were adequately informed about HPV, which is a concern. There were significant gaps in knowledge and more education is required to ensure misinformation and stigma do not inadvertently result from interactions between health professionals and patients," Dr. Bromhead says.
HPV is responsible for 99.7 per cent of cases of cervical cancer, along with some head and neck, penal and anal cancers. There are approximately 150 new diagnoses and 50 deaths from cervical cancer in New Zealand each year.
"In addition, there are longstanding ethnic inequalities in cervical cancer incidence and mortality, and cervical cancer screening coverage remains low for Māori and Pacific women," Dr. Bromhead says.
"Worryingly, 13 per cent of respondents either believed HPV causes HIV/AIDS or were unclear that it did not," she says.
Previous studies have highlighted that the public are generally not well informed about HPV and its impact on health, and the sexually transmitted nature of HPV may bring a stigma to its diagnosis. "Therefore a lack of knowledge among health professionals is worrying for its impact on women's engagement with cervical screening," Dr. Bromhead says.
"Most concerning was the finding that less than 10 per cent of all health professionals surveyed could correctly answer all questions about the current cervical screening guidelines, which have been in place since 2008," Dr. Bromhead says. "Our analyses showed that this knowledge could be predicted by the number of years since training took place. We need to ensure career-long learning about HPV is integrated into routine practice for smear takers, nurses, GPs, colposcopists, gynaecologists and other specialists taking care of women's health."
Respondents also provided suggestions for how training might be improved. "They wanted regular updates, more training sessions, and several health professionals felt that online training or online resources such as research, frequently asked questions and updates would be useful. With a change to HPV primary screening coming, we hope this work will provide a baseline from which various agencies can build robust continuing medical education programmes for all levels of healthcare providers involved in the screening pathway," Dr. Bromhead says.