Implementing HPV Self-Collection Tests in Primary Care: A Discussion with Ada Stewart, MD

As HPV self-collection testing becomes available in clinical settings, primary care physicians face new considerations for implementation. While self-collection provides an important screening option for patients who may otherwise avoid cervical cancer screening, clinicians must be prepared to discuss its benefits, risks, and limitations. In this interview with Patient Care, Ada Stewart, MD, a board-certified family physician and past president of the American Academy of Family Physicians, shares strategies for integrating HPV self-collection into practice. She emphasizes the importance of clear patient communication, ensuring reliable follow-up in the event of abnormal results, and addressing barriers such as unreliable phone access or lack of transportation that can disproportionately affect patients in underserved communities.

The following transcript has been lightly edited for flow and style.

Patient Care: Do you have any tips for physicians who are implementing HPV self-collection tests in their practice, perhaps for the first time?

Ada Stewart, MD: Yes. First, it’s important to talk to patients about the benefits, risks, and limitations. Even though it’s a self-collection test, at this point it should be done in a clinical setting. Patients need clear instructions, and that may include having a nurse explain the process and what to expect while they collect their sample.

Patients also need to understand that if results are abnormal, they must return for follow-up and a speculum exam. That can be challenging, especially in communities with health disparities and social determinants of health barriers. For example, I may try to call a patient, but their phone number no longer works, or they may not have transportation to return to the clinic. These are issues we have to address upfront—making sure we have reliable contact information and confirming that they can come back if needed.

It’s critical that patients are well informed and that clinicians stay up to date on the limitations of self-collection. Shared decision-making between clinician and patient is the best way to ensure we provide optimal care and do not miss opportunities to prevent cervical cancer.